Provider Demographics
NPI:1386995652
Name:CHANG, JHIA-MING (DDS)
Entity type:Individual
Prefix:DR
First Name:JHIA-MING
Middle Name:
Last Name:CHANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10527 BRADDOCK RD.
Mailing Address - Street 2:STE. 8A
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22032
Mailing Address - Country:US
Mailing Address - Phone:703-352-2073
Mailing Address - Fax:703-352-1541
Practice Address - Street 1:10527 BRADDOCK RD.
Practice Address - Street 2:STE. 8A
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22032
Practice Address - Country:US
Practice Address - Phone:703-352-2073
Practice Address - Fax:703-352-1541
Is Sole Proprietor?:No
Enumeration Date:2012-09-27
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0394411223G0001X
VA04014141361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice