Benjamin W Song, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 21794 Issued in FL

Practice address

2053 Palm Vista Drive
Apopka, FL 32712

Phone

(386) 235-6683

NPI assigned

Sep 19, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1316390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476835200000",
    "number": "1790067460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2053 PALM VISTA DR",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "327122454",
            "telephone_number": "386-235-6683"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2053 PALM VISTA DRIVE",
            "city": "APOPKA",
            "state": "FL",
            "postal_code": "32712",
            "telephone_number": "386-235-6683"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "BENJAMIN",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-19",
        "last_updated": "2016-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 21794",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Soleva Health & Wellness LLC
• David Solis, LICENSED OPTICIAN
• Solome Health Systems L.L.C.
• Lovina Solomon, RN
• Stephen Jay Somerville, D.C.
• Linda M Soper Maier, DDS
• Shana Sopko, M.A.
• Diane Marie Soto, PHARMD
• Israel Soto
• Nichole Guess Spaulding, LCSW

• General Practice Dentistry in Apopka, FL
• Providers in Apopka, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.