IndividualActive
Song Rhim, D.M.D.
NPI 1336369750 · Periodontics · Jbsa Lackland, TX
Provider details
- NPI number
- 1336369750
- Entity type
- Individual
- Primary specialty
- PeriodonticsDental Providers
- Credential
- D.M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 62275 (CA)
Specialties & taxonomies
Dental Providers
Dental Providers
Dental Providers
Dental Providers
Profile Score
Detailed profile(98/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
2133 Pepperrell St
Jbsa Lackland, TX 78236-5313
Phone: (210) 292-2558
Approximate (ZIP-level) locationGet directions
Mailing address
2133 Pepperrell St
Jbsa Lackland, TX 78236-5313
Additional practice locations (2)
- 374th Medical GroupYokota Air BaseApo, AP 96326Phone: (315) 225-9700
- 151 Bodin CirTravis Afb, CA 94535-1801Phone: (707) 423-7055Fax: (707) 423-1711
Registry dates
- Enumerated
- 2007-04-26
- Last updated
- 2021-01-05
- Certified
- 2021-01-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.