Insoo Song, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

35046 Issued in TX

Practice address

1628 W Hebron Pkwy Ste 108
Carrollton, TX 75010-6311

Phone

(972) 492-0002

NPI assigned

Jun 28, 2018

Sex

Male

Sole proprietor

Yes

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

State licenses

Practice roles

Locations

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.

• Song Dental PLLC

  • General Practice Dentistry
  • Carrollton, TX
  • NPI 1144937913
  NPD Authorized official
• Tcid PLLC

  • General Practice Dentistry
  • Carrollton, TX
  • NPI 1649802984
  NPD Authorized official
• Happy Teeth PLLC

  • General Practice Dentistry
  • Fort Worth, TX
  • NPI 1225739311
  NPD (past)

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

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597104000000",
    "number": "1821583113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1628 W HEBRON PKWY STE 108",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106311",
            "telephone_number": "972-492-0002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1628 W HEBRON PKWY STE 108",
            "city": "CARROLLTON",
            "state": "TX",
            "postal_code": "750106311",
            "telephone_number": "972-492-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "INSOO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-28",
        "last_updated": "2020-08-11",
        "certification_date": "2020-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "35046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• SE Jin Son, DPT
• Song Dental PLLC
• Song Dermatology PLLC
• Alexander Song, PHARMD
• Edward Song, L.AC., PH.D.
• Mi Hye Song, MD
• Sonus-Texas, Inc.
• Sony C Markose D.D.S., P.C
• Ashraf A Soomar-Kheraj, D.C.
• Jennifer Soper

• Dentist in Carrollton, TX
• Providers in Carrollton, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 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.