IN HEE SONG DMD MD INC NPI 1144092479

NPI Information

  • NPI: 1144092479
  • Provider Name: IN HEE SONG DMD, MD, INC
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • Address: 1004 FOWLER WAY STE 9
    PLACERVILLE, CA
    ZIP 95667
  • Phone: (530) 328-0360

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NPI Details

IN HEE SONG DMD, MD, INC is an oral and maxillofacial surgery dentist in Placerville, CA. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. IN HEE SONG DMD, MD, INC NPI is 1144092479. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1004 FOWLER WAY STE 9
PLACERVILLE, CA
ZIP 95667-746
Phone: (530) 328-0360
Fax: (530) 328-0365

The provider's authorized official is In Hee Song .
The authorized official title is Ceo and has the following contact phone number (530) 328-0360.

The enumeration date for this NPI number is 10/30/2023 and was last updated on 2/10/2025.

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
11223S0112XDentistOral and Maxillofacial SurgeryYes

What is NPI?

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This page was last updated on: 11/21/2025

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