Provider Demographics
NPI:1386706729
Name:CHANG, HANN GUANG (DDS)
Entity type:Individual
Prefix:
First Name:HANN GUANG
Middle Name:
Last Name:CHANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:BILLY
Other - Middle Name:H G
Other - Last Name:CHANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1895 MOWRY AVENUE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94538
Mailing Address - Country:US
Mailing Address - Phone:510-791-7522
Mailing Address - Fax:510-791-8437
Practice Address - Street 1:1895 MOWRY AVENUE
Practice Address - Street 2:SUITE 105
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94538
Practice Address - Country:US
Practice Address - Phone:510-791-7522
Practice Address - Fax:510-791-8437
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA35857122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist