Shi Guang Song, DMD is a
Student In An Organized Health Care Education/training Program based in Corvallis, Oregon. Shi Guang Song is licensed to practice in * (Not Available) (license number ) and her current practice location is
1731 Nw Kings Blvd, Corvallis, Oregon. She can be reached at her office (for appointments etc.) via phone at
(541) 705-2470.
NPI number for Shi Guang Song is 1528740149 and her current mailing address is 777 Commercial St Se #510, Salem, Oregon. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1528740149.
Healthcare Provider's Profile
| Full Name | Shi Guang Song |
|---|
| Gender | Female |
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| Speciality | Student In An Organized Health Care Education/training Program |
|---|
| Location | 1731 Nw Kings Blvd, Corvallis, Oregon |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1528740149
- Provider Enumeration Date: 08/03/2023
- Last Update Date: 10/09/2025
Medical Identifiers
Medical identifiers for Shi Guang Song such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1528740149 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 012248 (Oregon) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Shi Guang Song is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Shi Guang Song, DMD
777 Commercial St Se #510,
Salem, OR 97301
Ph: (267) 815-3792 | Shi Guang Song, DMD
1731 Nw Kings Blvd,
Corvallis, OR 97330
Ph: (541) 705-2470 |
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