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Organization
SONG PERIODONTICS AND DENTAL IMPLANTS PLLC
Active
Organization
SONG PERIODONTICS AND DENTAL IMPLANTS PLLC
Active
Other names
Pacific Northwest Oral Medicine, Pacific Northwest Periodontics, SONG PERIODONTICS AND DENTAL IMPLANTS, PACIFIC NW PERIODONTICS
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HYUN JUNG SONG (OWNER)
(206) 575-1086
Entity
Organization
Contact information
Practice address
411 STRANDER BLVD STE 302, TUKWILA, WA 98188-2924
(206) 575-1086
Mailing address
411 STRANDER BLVD STE 302, TUKWILA, WA 98188-2924
(206) 575-1086
(206) 575-0829
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
—
—
261QD0000X
Dental Clinic/Center
—
—
332BC3200X
Customized Equipment (DME)
—
—
Other
Enumeration date
06/03/2019
Last updated
04/21/2026
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