Active NPI
Hae Min Song
- Pediatric Dentistry
- Aurora, CO
National Provider Identifier
1699667428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- 00205990
- Practice address
- 860 Potomac Cir
Aurora, CO 80011-6714 - Phone
- (720) 777-6788
- NPI assigned
- Jul 16, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 00205990 | CO | Primary |
Addresses
Primary practice location
860 Potomac Cir
Aurora, CO 80011-6714
Mailing address
8355 E 32ND Ave Apt 281
Denver, CO 80238-4432
Phone (412) 482-0484
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00205990 | CO | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1752624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1752624000000",
"number": "1699667428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8355 E 32ND AVE APT 281",
"city": "DENVER",
"state": "CO",
"postal_code": "802384432",
"telephone_number": "412-482-0484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "860 POTOMAC CIR",
"city": "AURORA",
"state": "CO",
"postal_code": "800116714",
"telephone_number": "720-777-6788"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG",
"first_name": "HAE MIN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-07-16",
"last_updated": "2025-07-16",
"certification_date": "2025-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "CO",
"license": "00205990",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.