Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
SHI GUANG SONG, DMD
Deactivated Sole ProprietorSHI GUANG SONG, DMD is a Pediatric Dentistry healthcare provider located in CORVALLIS, Oregon. NPI 1528740149 is deactivated in the NPPES registry. Verify at CMS.
Pediatric Dentistry · CORVALLIS, OR
This NPI has been deactivated.
The record was deactivated on March 15, 2024.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1528740149
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 3, 2023 (0.61475409836066 yrs)
- Last Updated
- Nov 10, 2025
- Deactivated
- Mar 15, 2024
- License
-
012248 (OR)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1731 NW KINGS BLVDCORVALLIS, OR, 97330Browse OR providers · Browse ZIP 97330
- Phone
- 5417052470
- Primary Specialty
-
Pediatric Dentistry
1223P0221X
- Additional Specialty
- Student (Health Education/Training)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.