Provider Demographics
NPI:1285147926
Name:CHRIS H. CHANG DDS, INC
Entity type:Organization
Organization Name:CHRIS H. CHANG DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:951-325-4600
Mailing Address - Street 1:5337 HAMNER AVE UNIT 707
Mailing Address - Street 2:
Mailing Address - City:EASTVALE
Mailing Address - State:CA
Mailing Address - Zip Code:91752-1042
Mailing Address - Country:US
Mailing Address - Phone:951-325-4600
Mailing Address - Fax:951-325-4494
Practice Address - Street 1:5337 HAMNER AVE UNIT 707
Practice Address - Street 2:
Practice Address - City:EASTVALE
Practice Address - State:CA
Practice Address - Zip Code:91752-1042
Practice Address - Country:US
Practice Address - Phone:951-444-8164
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-15
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental