Provider Demographics
NPI:1093517138
Name:ANDREW CHANG, DDS
Entity type:Organization
Organization Name:ANDREW CHANG, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:H
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-951-6314
Mailing Address - Street 1:107 COLUMBIA HTS APT 7G
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-7335
Mailing Address - Country:US
Mailing Address - Phone:917-951-6314
Mailing Address - Fax:
Practice Address - Street 1:815 HUTCHINSON RIVER PKWY STE 845
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10465-0368
Practice Address - Country:US
Practice Address - Phone:718-509-9152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-27
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty