Organization
JINJU SONG DMD PLLC
Active
Other names
Juanita Kids Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
JINJU SONG DMD (OWNER/DOCTOR)
(425) 310-8338
Entity
Organization
Contact information
Practice address
9707 NE 119TH WAY, KIRKLAND, WA 98034-8955
(425) 310-8338
(425) 449-5933
Mailing address
9707 NE 119TH WAY, KIRKLAND, WA 98034-8955
(425) 310-8338
(425) 449-5933
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DE60300517
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1255644316
INDIVIDUAL NPI
—
01
—
DE60300517
LICENSE
WA
Enumeration date
06/08/2018
Last updated
06/08/2018
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