Edmund Song

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

065440 Issued in NY

Practice address

9203 Roosevelt Ave
Jackson Heights, NY 11372-7941

Phone

(516) 362-1001

NPI assigned

Sep 28, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1727481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1699593780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 BROADWAY",
            "address_2": "DEPARTMENT OF DENTISTRY & OMS, SUITE 2C-319",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11206",
            "telephone_number": "718-963-8308",
            "fax_number": "718-963-8317"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9203 ROOSEVELT AVE",
            "city": "JACKSON HEIGHTS",
            "state": "NY",
            "postal_code": "113727941",
            "telephone_number": "516-362-1001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "EDMUND",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-09-28",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "065440",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason J Sol, DDS
• Fahad R Solaiman
• Bipin Solanki, M.D
• Priti Prashant Solanki
• Arlene Somach
• Hyunja Song
• Sonria Dental Care P.C.
• Cora Sorenson
• Stephanie Alexandra Sosa-Bravo
• Debora J Sosa, LMSW

• General Practice Dentistry in Jackson Heights, NY
• Providers in Jackson Heights, 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 Aug 19, 2026; 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.