Individual provider Active NPI

Ning Chang, DDS

  • General Practice Dentistry
  • Henderson, NV
National Provider Identifier
1003265091
Registry record updated Jul 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
7058 Issued in NV
Practice address
680 S Green Valley Pkwy Ste 100
Henderson, NV 89052-0438
Phone
(702) 444-7771
Fax
(702) 444-7934
NPI assigned
Jun 9, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 14, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 7058 NV Primary

Addresses

Primary practice location

680 S Green Valley Pkwy Ste 100
Henderson, NV 89052-0438

Mailing address

680 S Green Valley Pkwy Ste 100
Henderson, NV 89052-0438
Phone (702) 444-7771

Other practice location 1

2215 Fuller Road
AAVAMC - Dental Service (160)
Ann Arbor, MI 48105-9923
Phone (734) 845-3528

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160810000700 MI Order and Referring Only - DentistPractitioner - Dentist 5890089163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7058NVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Grace H Chung, PLLC CurrentSince Jan 14, 2024 Accepting new patients

Locations

680 S Green Valley Pkwy
Ste 100
Henderson, NV 89052
Phone (702) 444-7771

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626220800000",
    "number": "1003265091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "680 S GREEN VALLEY PKWY STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890520438",
            "telephone_number": "702-444-7771",
            "fax_number": "702-444-7934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 S GREEN VALLEY PKWY STE 100",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890520438",
            "telephone_number": "702-444-7771",
            "fax_number": "702-444-7934"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2215 Fuller Road",
            "address_2": "AAVAMC - Dental Service (160)",
            "address_purpose": "LOCATION",
            "city": "Ann Arbor",
            "state": "MI",
            "postal_code": "481059923",
            "country_code": "US",
            "telephone_number": "734-845-3528",
            "fax_number": "734-845-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "NING",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2021-07-14",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "7058",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Henderson, NV

Sources for this page

Verify at the official NPI Registry.