NPIMap

Individual provider Active NPI

Lindsey Stephanie Chang, DMD, INC.

  • Endodontics
  • Folsom, CA
National Provider Identifier
1003255217
Registry record updated Nov 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DDS104537 Issued in CA
Practice address
2465 Iron Point Rd Ste 120
Folsom, CA 95630-8754
Phone
(916) 984-9600
Fax
(916) 984-9076
NPI assigned
Jun 20, 2013
Last updated
Nov 22, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 22, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN20167 FL
Endodontics 1223E0200X DN20167 FL
Endodontics 1223E0200X DDS104537 CA Primary

Addresses

Primary practice location

2465 Iron Point Rd Ste 120
Folsom, CA 95630-8754

Mailing address

2521 Worthington St Apt 307
Dallas, TX 75204-2585
Phone (954) 809-1255

Other practice location 1

2190 E Bidwell St
Folsom, CA 95630-6453
Phone (916) 984-0304

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DDS104537CAMDEndodontist
DN20167FLMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
S.Y. Jang DDS Corporatiom Past Accepting new patients
O'Donnell Dental Corporation PastSince Oct 20, 2019 Accepting new patients
Tavallaei, D.M.D., Corporation Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1371686400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574380800000",
    "number": "1003255217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2521 WORTHINGTON ST APT 307",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752042585",
            "telephone_number": "954-809-1255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2465 IRON POINT RD STE 120",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956308754",
            "telephone_number": "916-984-9600",
            "fax_number": "916-984-9076"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2190 E Bidwell St",
            "address_purpose": "LOCATION",
            "city": "Folsom",
            "state": "CA",
            "postal_code": "956306453",
            "country_code": "US",
            "telephone_number": "916-984-0304",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "LINDSEY",
        "middle_name": "STEPHANIE",
        "name_prefix": "Dr.",
        "credential": "DMD, INC.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-20",
        "last_updated": "2019-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN20167",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "FL",
            "license": "DN20167",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "DDS104537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.