Individual provider Active NPI

Jianing Song, DMD

  • Dentist
  • Riverside, CA
National Provider Identifier
1376420497
Registry record updated Aug 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
111936 Issued in CA
Practice address
3297 Arlington Ave Ste 101
Riverside, CA 92506-3250
Phone
(585) 386-9210
NPI assigned
Aug 20, 2025
Last updated
Aug 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 111936 CA Primary

Addresses

Primary practice location

3297 Arlington Ave Ste 101
Riverside, CA 92506-3250

Mailing address

6307 Nuffield CT
Eastvale, CA 92880-8569

Other practice location 1

1312 E Ontario Ave Ste 102
Corona, CA 92881-6645
Phone (951) 273-0370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
111936CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Corporation of Charles Rodgers, DDS Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1755648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755648000000",
    "number": "1376420497",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6307 NUFFIELD CT",
            "city": "EASTVALE",
            "state": "CA",
            "postal_code": "928808569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3297 ARLINGTON AVE STE 101",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925063250",
            "telephone_number": "585-386-9210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1312 E Ontario Ave Ste 102",
            "address_purpose": "LOCATION",
            "city": "Corona",
            "state": "CA",
            "postal_code": "928816645",
            "country_code": "US",
            "telephone_number": "951-273-0370",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SONG",
        "first_name": "JIANING",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-08-20",
        "last_updated": "2025-08-20",
        "certification_date": "2025-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "111936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.