Individual provider Active NPI

Wendy Song, DDS

  • General Practice Dentistry
  • Jenkintown, PA
National Provider Identifier
1730671215
Registry record updated Jan 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DS043784 Issued in PA
Practice address
201 Old York Rd Ste 200
Jenkintown, PA 19046-3707
Phone
(215) 576-0421
NPI assigned
May 31, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DS043784 PA Primary
General Practice Dentistry 1223G0001X 11014 NC

Addresses

Primary practice location

201 Old York Rd Ste 200
Jenkintown, PA 19046-3707

Mailing address

4629 Spruce St
Philadelphia, PA 19139-4542

Other practice location 1

1801 E Franklin St
Chapel Hill, NC 27514-5855
Phone (919) 929-3996

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

LicenseStateTypeSpecialty
DS043784PAMDGeneral Practice Dentistry
11014NCMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Harry S Taub, DDS & Associates PC PastSince Jan 8, 2023 Accepting new patients
Dinah B Vice DDS PA Past Accepting new patients
White Pearl Dentistry PLLC PastSince Jan 8, 2023 Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672963200000",
    "number": "1730671215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4629 SPRUCE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191394542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 OLD YORK RD STE 200",
            "city": "JENKINTOWN",
            "state": "PA",
            "postal_code": "190463707",
            "telephone_number": "215-576-0421"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1801 E Franklin St",
            "address_purpose": "LOCATION",
            "city": "Chapel Hill",
            "state": "NC",
            "postal_code": "275145855",
            "country_code": "US",
            "telephone_number": "919-929-3996",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONG",
        "first_name": "WENDY",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-31",
        "last_updated": "2023-01-06",
        "certification_date": "2023-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS043784",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "11014",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jenkintown, PA

Sources for this page

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