Ken William Song, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7508 Issued in WA

Practice address

14432 Military Rd S Ste 3
Tukwila, WA 98168-5303

Phone

(206) 242-2881

Fax

(206) 242-2880

NPI assigned

Jul 19, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Enrolled in WA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ken W. Song, DDS, PS

  • Dentist
  • Tukwila, WA
  • NPI 1376657379
  NPD (past) Authorized official

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

{
    "created_epoch": "1153267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1952320657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14432 MILITARY RD S STE 3",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981685303",
            "telephone_number": "206-242-2881",
            "fax_number": "206-242-2880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14432 MILITARY RD S STE 3",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981685303",
            "telephone_number": "206-242-2881",
            "fax_number": "206-242-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SONG",
        "first_name": "KEN",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "7508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Cicero Son, RC
• Song Periodontics and Dental Implants PLLC (Pacific Northwest Oral Medicine)
• Song Periodontics and Implants (Pacific northwest oral medicine)
• Ellie Song, DDS
• Hyun Jung Song, DDS MSD
• Anjoo Sood
• Rebecca Sosnovske
• Sound
• Sound Pain Alliance (Tukwila Ambulatory Surgery Center)
• Sound Pain Alliance (Puget Sound Pain Clinic)

• General Practice Dentistry in Tukwila, WA
• Providers in Tukwila, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.