Jaemin Song

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

062257 Issued in NY

Practice address

145 Canal St FL 2
New York, NY 10002-5033

Phone

(917) 388-3678

NPI assigned

Apr 30, 2020

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bowery Dental

  • General Practice Dentistry
  • New York, NY
  • NPI 1245727064
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1588204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1497376560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2935 JOHN F KENNEDY BLVD APT 610",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073063881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 CANAL ST FL 2",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100025033",
            "telephone_number": "917-388-3678"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 Martin Luther King Blvd",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021191868",
            "country_code": "US",
            "telephone_number": "617-427-4242",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1775 Grand Concourse Fl 6",
            "address_2": "BronxCare Health Systems, Dept of Dentistry",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104538202",
            "country_code": "US",
            "telephone_number": "718-901-8410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONG",
        "first_name": "JAEMIN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-30",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "062257",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "DN1858981",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Day Song, M.D.
• Esther Song
• Hae Rim Song, MD
• Hyun Kyu E Song, DDS
• Jae Wook Song, O.D.
• Jane Song, D.D.S
• Jane Song, M.D.
• Je Lim Song
• Jenny Won Song, FNP
• Jiwon Song

• General Practice Dentistry in New York, NY
• Providers in New York, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.