DR. JONATHAN SONG (NPI# 1336595651) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336595651 |
| Entity Type | Individual |
| Full Name | DR. JONATHAN SONG |
| Credential | D.M.D. |
| Practice Address |
115 W Seminary Dr Suite 101 Fort Worth TX 76115-2635 |
| Practice Telephone | 8174050195 |
| Mailing Telephone | 8174050195 |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2016-05-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 31771 | TX | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659757375 | Jonathan Song | Dentist | 1134 N State College Blvd Ste C, Anaheim, CA 92806 | 2015-08-04 |
| 1902260227 | Jonathan K Song | Internal Medicine | 1401 S California Ave, Chicago, IL 60608 | 2016-04-12 |
| 1336265495 | Jonathan Song | Acupuncturist | 6255 University Ave, Suite 202, Middleton, WI 53562-3485 | 2007-03-21 |
| 1851452775 | Jonathan Y Song | Obstetrics & Gynecology | 2455 Dean St, Suite A, Saint Charles, IL 60175-4830 | 2006-12-13 |
| 1508957564 | Jonathan Cheng Song | Ophthalmology | 1450 San Pablo St, Los Angeles, CA 90033-4500 | 2006-09-27 |
| Street Address |
115 W SEMINARY DR SUITE 101 |
| City | FORT WORTH |
| State | TX |
| Zip Code | 76115-2635 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073921367 | Chen Yuan Mao | Dentist | 115 W Seminary Dr, Suite 101, Fort Worth, TX 76115-2635 | 2014-07-30 |
| 1992251011 | Annie Bae | Dentist | 115 W Seminary Dr, Fort Worth, TX 76115-2635 | 2016-08-29 |
| 1932503117 | Donghyun Kim | Dentist | 115 W Seminary Dr, Fort Worth, TX 76115-2635 | 2014-10-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811400047 | Christine Vera Varela | Nurse Practitioner | Clinicas Mi Doctor, 4200 S Freeway Ste 106, Fort Worth, TX 76115 | 2017-11-09 |
| 1376081752 | Cheryl D. Mitchell | Nurse Practitioner | 11803 S. Freeway, Ste. 311, Fort Worth, TX 76115 | 2017-02-06 |
| 1508097858 | Misti Lynne Poulos | Massage Therapist | 4534 Stanley Ave, #361, Fort Worth, TX 76115 | 2009-08-04 |
| 1609015312 | Sirisha Bheemaneni | Internal Medicine | 11801 S Frwy, Fort Worth, TX 76115 | 2009-02-19 |
| 1639378292 | Jeffrey J. Raymond | Physician Assistant | 544 West Seminary Dr, Fort Worth, TX 76115 | 2007-07-13 |
| 1336367952 | Luis Sierra-nieves | Physician Assistant | 544 West Seminary Drive, Fort Worth, TX 76115 | 2007-04-20 |
| 1396861209 | Remedios R Cabansag | Obstetrics & Gynecology | 11803 So Freewax, Suite 254, Fort Worth, TX 76115 | 2007-03-22 |
| 1073602611 | Courage Rehab Clinic | Clinic/Center | 1670 North Hampton Road, Suite 110, Desoto, TX 76115 | 2006-10-12 |
| 1548369200 | Vijay Khanna | Podiatrist | 4759 B South Freeway, Ft Worth, TX 76115 | 2006-09-21 |
| 1225045164 | Allan M Wallace | Optometrist | 11803 South Frwy, Suite 114, Fort Worth, TX 76115 | 2006-08-02 |
| Find all providers in zip 76115 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497354179 | Perla Dental of Keller Pa | Dentist | 5325 Golden Triangle Blvd Ste 100, Fort Worth, TX 76244-4469 | 2020-10-22 |
| 1962028514 | Christopher Thomas Mathew | Dentist | 4744 Bryant Irvin Rd, Fort Worth, TX 76132-3646 | 2020-06-19 |
| 1376016469 | Brident Dental Associates PC | Dentist | 815 E Berry St Ste B, Fort Worth, TX 76110-4457 | 2019-01-10 |
| 1972089241 | Hulen Dental Partners Pplc | Dentist | 6217 Oakmont Blvd, Fort Worth, TX 76132-2812 | 2018-07-19 |
| 1811473499 | Oak View Family Dentistry Pllc | Dentist | 8201 N. Beach St. Unit 101, Fort Worth, TX 76244 | 2018-07-17 |
| 1184118465 | Lisa Tran | Dentist | 515 W Loop 820 N Ste 101, Fort Worth, TX 76108-1450 | 2018-06-19 |
| 1548772213 | Ideal Dental of West 7th Pllc | Dentist | 628 Harrold St Ste 124, Fort Worth, TX 76107-2323 | 2017-11-02 |
| 1396269429 | Matthew Pedroza | Dentist | 4625 Feathercrest Dr., Fort Worth, TX 76137 | 2017-07-31 |
| 1083138341 | Shakti Darshan Pllc | Dentist | 10313 Roatan Trl, Fort Worth, TX 76244-2039 | 2017-07-28 |
| 1336662022 | Ben Luka | Dentist | 639 Alta Mere Dr, Fort Worth, TX 76114 | 2017-07-25 |
| Find all providers in FORT WORTH | ||||
| City | FORT WORTH |
| Zip Code | 76115 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.