Individual Healthcare Provider
Soo Kyung Song, DDS, MS
Provider's NPPES record last updated: October 8, 2025
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1750740072
- Primary Specialty
- Dentist — Pediatric Dentistry
- Practice Location
- Pasadena, California
- Sole Proprietor
- Yes
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 21, 2026, 9:49 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Dentist
Pediatric Dentistry
Dental Providers
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
Taxonomy code 1223P0221X
Provider-Reported License Information
- Dentist (California)
- 101142
Practice Locations
Practice Location
686 E Union Street
Suite 150
Pasadena, California 91101-5828
Phone: (626) 460-1002
Additional Practice Location
4608 Katella Ave Ste 101
Los Alamitos, California 90720-2685
Phone: (562) 596-8668
Additional Practice Location
1610 W Edinger Ave Ste C
Santa Ana, California 92704-4339
Phone: (714) 432-7337
Record Information
- Enumeration Date
- February 15, 2016
- Provider's NPPES Record Last Updated
- October 8, 2025
- Certification Date
- October 8, 2025
- NPISignal NPPES Dataset
- August 2026
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