DR. EUN SUP SONG DDS NPI 1053507087

NPI Information

  • NPI: 1053507087
  • Provider Name: DR. EUN SUP SONG, DDS
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • Address: 2777 FOOTHILL BLVD
    LA CRESCENTA, CA
    ZIP 91214
  • Phone: (818) 957-7878

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NPI Details

DR. Eun Sup Song, DDS is a general practice dentist in La Crescenta, CA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Eun Sup Song, DDS NPI is 1053507087. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2777 FOOTHILL BLVD
LA CRESCENTA, CA
ZIP 91214
Phone: (818) 957-7878
Fax: (818) 957-7978

The enumeration date for this NPI number is 9/24/2007 and was last updated on 9/24/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice42003CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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