Provider Demographics
NPI:1851829030
Name:CHANG, KATIE LEIGH (DDS)
Entity type:Individual
Prefix:DR
First Name:KATIE
Middle Name:LEIGH
Last Name:CHANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26919 CHEYENNE CREST LN
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-3639
Mailing Address - Country:US
Mailing Address - Phone:225-278-8182
Mailing Address - Fax:
Practice Address - Street 1:11757 KATY FWY STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77079-1752
Practice Address - Country:US
Practice Address - Phone:346-230-4831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-31
Last Update Date:2025-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34453122300000X, 1223G0001X
LA67591223D0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
No1223D0001XDental ProvidersDentistDental Public Health