NPIMap

Organization Active NPI

Dr. Isse Song Dental Office

  • General Practice Dentistry
  • Orlando, FL
National Provider Identifier
1659319655
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN11703 Issued in FL
Legal business name
DR. ISSE SONG DENTAL OFFICE
Practice address
12554 S John Young Pkwy
#104
Orlando, FL 32837-4004
Phone
(407) 888-1088
Fax
(407) 888-1889
NPI assigned
Jun 2, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Isse Song, D.M.DNPI 1003238650
Title
D.M.D., PH. D.,Fagd/ Doctor
Phone
(407) 888-1088

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X DN11703 FL Primary

Addresses

Primary practice location

12554 S John Young Pkwy
#104
Orlando, FL 32837-4004

Mailing address

12554 S John Young Pkwy
#104
Orlando, FL 32837-4004
Phone (407) 888-1088

National Provider Directory

National Provider Directory
Tax ID family
Dr Isse Song Dental Office2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1659319655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12554 S JOHN YOUNG PKWY",
            "address_2": "#104",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328374004",
            "telephone_number": "407-888-1088",
            "fax_number": "407-888-1889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12554 S JOHN YOUNG PKWY",
            "address_2": "#104",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328374004",
            "telephone_number": "407-888-1088",
            "fax_number": "407-888-1889"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. ISSE SONG DENTAL OFFICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SONG",
        "authorized_official_first_name": "ISSE",
        "authorized_official_title_or_position": "D.M.D., PH. D.,FAGD/ DOCTOR",
        "authorized_official_telephone_number": "407-888-1088",
        "authorized_official_credential": "D.M.D"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN11703",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.