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DR. SONG YONG PARK D.M.D
NPI 1225486947
Dentist in Buffalo, NY

Active since June 03, 2016PECOS Enrolled
34 BENWOOD AVE, BUFFALO, NY 14214(716) 986-9199(716) 342-2340 Get Directions Write a Review

NPPES record last updated: June 11, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Song Yong Park D.m.d NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SONG YONG PARK D.M.D (NPI 1225486947) is an individual dentist in Buffalo, New York, licensed in New York (059200) and active in the NPI registry since June 2016. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1225486947
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameDR. SONG YONG PARKCredential: D.M.D
Location Address34 BENWOOD AVEBuffalo, NY 14214-1761
Mailing Address34 Benwood AveBuffalo, NY 14214-1761 · (716) 986-9199 · Fax (716) 342-2340
Phone(716) 986-9199
Fax(716) 342-2340
Sole ProprietorNo
Enumeration DateJune 3, 2016
Last NPPES UpdateJune 11, 2026
NPPES CertifiedJune 11, 2026
✔ NPI 1225486947 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in NY · 059200
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
34 BENWOOD AVE, Buffalo, NY 14214
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Other Identifiers 1

Medicaid04880291NY

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Song Yong Park D.m.d is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

3

Medicare enrollment records show Song Park reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Community Health Center Of Buffalo, Inc.
Same address
Federally Qualified Health Center (FQHC)
34 BENWOOD AVE
Buffalo, NY 14214
  • Reassigned Medicare billing, New York enrollment
  • 44 clinicians in this Medicare group
NPI 1790787919 (716) 986-9199
Syracuse Community Health Center
136 mi
Federally Qualified Health Center (FQHC)
930 S SALINA ST
Syracuse, NY 13202
  • Reassigned Medicare billing, New York enrollment
  • 87 clinicians in this Medicare group
NPI 1184886988 (315) 476-7921
St Regis Mohawk Tribe
250 mi
Federally Qualified Health Center (FQHC)
412 STATE ROUTE 37
Akwesasne, NY 13655
  • Reassigned Medicare billing, New York enrollment
  • 27 clinicians in this Medicare group
NPI 1457344558 (518) 358-3141

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 14214 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$84.93 typical visit price
range $54.87 – $166.88
Typical copayment $21.23 (range $13.71 – $41.72)
Most-billed visit code 99203
Established Patient
$68.57 typical visit price
range $17.54 – $136.14
Typical copayment $17.14 (range $4.38 – $34.03)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

AHMAD MAFI DO
Internal Medicine
34 BENWOOD AVE
BUFFALO, NY 14214
Erie County (716) 986-9199
DR. KIRK A SCIRTO MD
Family Medicine
34 BENWOOD AVE
BUFFALO, NY 14214
Erie County (716) 986-9199
MS. KIMBERLEY MARIE HOLLIS PHD
Social Worker
34 BENWOOD AVE
BUFFALO, NY 14214
Erie County (716) 986-9199
JEANNETHE KING
Physical Therapist
34 BENWOOD AVE
BUFFALO, NY 14214
Erie County (716) 986-9199
NOOR AMJAD AREF MSW
Counselor
34 BENWOOD AVE
BUFFALO, NY 14214
Erie County (716) 986-9199
DR. BHARAT KOHLI MD
Family Medicine
34 BENWOOD AVE
BUFFALO, NY 14214
Erie County (716) 572-3053
SAMANTHA MEIERER
Physician Assistant
34 BENWOOD AVE
BUFFALO, NY 14214
Erie County (716) 986-9199
SHAHLA AHMAD M.D.
Family Medicine
34 BENWOOD AVE
BUFFALO, NY 14214
Erie County (716) 986-9199

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Song Park's NPI number?

The NPI number for Song Park is 1225486947. It was assigned to this individual provider in the NPPES registry on June 3, 2016.

Where is Song Park located?

Song Park practices at 34 Benwood Ave, Buffalo, NY 14214. The listed phone number is (716) 986-9199.

What is Song Park's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Song Park enrolled in Medicare?

Yes. Song Park is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Song Park's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Song Park reassigns Medicare benefits to 3 organizations: Community Health Center Of Buffalo, Inc. (Buffalo, NY), Syracuse Community Health Center (Syracuse, NY) and St Regis Mohawk Tribe (Akwesasne, NY). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Song Park's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Song Park accept?

Health plans from BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Florida Combined Life and 5 other insurers list Song Park as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Song Park was last updated on June 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.