Samuel Myeongsup Song, DDS
Dentist, General Practice in Los Angeles, CA. Individual provider (NPI-1).
NPI number1073432373
StatusActive
Last updated in NPPESJul 13, 2026
Details
- NPI
- 1073432373
- Entity type
- Individual (NPI-1)
- Name
- Samuel Myeongsup Song
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jul 13, 2026
- Certification date
- Jul 13, 2026
- Last updated
- Jul 13, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1223G0001X | Dentist, General Practice | 113444 | CA | Yes |
Practice location
2500 W 8th St Ste 106Los Angeles, CA 90057-3860
Phone 213-381-2827
Mailing address
2500 W 8th St Ste 106Los Angeles, CA 90057-3860
Phone 213-381-2827
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