Individual provider Active NPI

Seunghee Song

  • General Practice Dentistry
  • New Bedford, MA
National Provider Identifier
1871741983
Registry record updated Sep 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
22272 Issued in MA
Practice address
75 Wamsutta Street
Apt # 308
New Bedford, MA 02740
Phone
(857) 222-3741
NPI assigned
Sep 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 22272 MA Primary

Addresses

Primary practice location

75 Wamsutta Street
Apt # 308
New Bedford, MA 02740

Mailing address

145 Faunce Corner Rd Ste C
North Dartmouth, MA 02747-1263
Phone (508) 993-5900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20151120000369 MA Order and Referring Only - DentistPractitioner - Dentist 2860792025

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22272MAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Alpha Dental Center of Dartmouth, LLC General Practice Past Accepting new patients

Organizations & group practices 1

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": "1220400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1220400000000",
    "number": "1871741983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 FAUNCE CORNER RD STE C",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "027471263",
            "telephone_number": "508-993-5900",
            "fax_number": "508-993-5912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 WAMSUTTA STREET",
            "address_2": "APT # 308",
            "city": "NEW BEDFORD",
            "state": "MA",
            "postal_code": "02740",
            "telephone_number": "857-222-3741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "SEUNGHEE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-03",
        "last_updated": "2008-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "22272",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bedford, MA

Sources for this page

Verify at the official NPI Registry.