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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

EDMUND SONG
NPI 1699593780
Dentist - General Practice in Jackson Heights, NY

Active since September 28, 2024
9203 ROOSEVELT AVE, JACKSON HEIGHTS, NY 11372(516) 362-1001 Get Directions Write a Review

NPPES record last updated: August 19, 2026. Verified against the NPPES registry weekly; last sync: September 06, 2026.

Record update history: Aug 19, 2026, Sep 28, 2024 (2 updates tracked since 2024).

About Edmund Song NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

EDMUND SONG (NPI 1699593780) is an individual general practice provider in Jackson Heights, New York, licensed in New York (065440) and active in the NPI registry since September 2024.

NPPES Registry Identity

NPI1699593780
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameEDMUND SONG
Location Address9203 ROOSEVELT AVEJackson Heights, NY 11372-7941
Mailing Address760 Broadway, Department Of Dentistry & Oms, Suite 2c-319Brooklyn, NY 11206 · (718) 963-8308 · Fax (718) 963-8317
Phone(516) 362-1001
Sole ProprietorNo
Enumeration DateSeptember 28, 2024
Last NPPES UpdateAugust 19, 20262 updates tracked since enumeration
NPPES CertifiedAugust 19, 2026
✔ NPI 1699593780 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in NY · 065440
Definition
A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.
9203 ROOSEVELT AVE, Jackson Heights, NY 11372
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Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CAROLINE KOSLOSKY DDS
Dentist
9203 ROOSEVELT AVE
JACKSON HEIGHTS, NY 11372
Queens County (718) 429-6622
TIANA NICHELLE TYNDALL DDS
Dentist (General Practice)
9203 ROOSEVELT AVE
JACKSON HEIGHTS, NY 11372
Queens County (718) 429-6622
DEBORAHNINADENTALOFFICEPC
Dentist (General Practice)
9203 ROOSEVELT AVE
JACKSON HEIGHTS, NY 11372
Queens County (718) 429-6622

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Edmund Song's NPI number?

The NPI number for Edmund Song is 1699593780. It was assigned to this individual provider in the NPPES registry on September 28, 2024.

Where is Edmund Song located?

Edmund Song practices at 9203 Roosevelt Ave, Jackson Heights, NY 11372. The listed phone number is (516) 362-1001.

What is Edmund Song's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Edmund Song was last updated on August 19, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 22 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.