Shi Guang Song, DMD
Shi Guang Song, DMD is a provider specialising in Pediatric Dentistry in Corvallis, OR, registered under NPI 1528740149. This provider registers 2 separate taxonomy codes, which usually means they practise across more than one recognised specialty. NPPES records them as a sole proprietor, meaning the practice is not incorporated as a separate legal entity.
Getting there
The practice address on file is 1731 NW KINGS BLVD, Corvallis, OR 97330. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| 012248 | OR | Pediatric Dentistry primary |
This provider holds licence 012248 issued in OR. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
What Pediatric Dentistry covers
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. NUCC Health Care Provider Taxonomy, code 1223P0221X
All registered taxonomy codes
This provider registers 2 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 1223P0221X | Pediatric Dentistry Pediatric Dentistry | 012248 | OR | primary |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | — |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-1 identifies a single person. It stays with the clinician for life, even if they move practice or change state, which is why the address on file can lag behind where they actually work today.
| NPI | 1528740149 valid check digit |
|---|---|
| Entity type | Individual (NPI-1) |
| Enumeration date | Aug 3, 2023 |
| Last updated | Nov 10, 2025 |
| Status | Active |
| Sole proprietor | Yes |
| Gender | Female |
| Credential | DMD |
| Practice address |
1731 NW KINGS BLVD Corvallis, OR 97330 (541) 705-2470 |
| Mailing address |
777 COMMERCIAL ST SE #510 Salem, OR 97301 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 5 | 2 | 8 | 7 | 4 | 0 | 1 | 4 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 5 | 4 | 8 | 5 | 4 | 0 | 1 | 8 |
Sum = 61 · next multiple of 10 = 70 · check digit = 9 · actual last digit = 9
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.