Active NPI
Lisa Ku Chang, D.D.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Bakersfield, CA
National Provider Identifier
1023334489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 56057
- Practice address
- 4409 Ming Ave
Bakersfield, CA 93309-4817 - Phone
- (661) 835-5811
- NPI assigned
- Apr 10, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 56057 | CA | Primary |
Addresses
Primary practice location
4409 Ming Ave
Bakersfield, CA 93309-4817
Mailing address
4409 Ming Ave
Bakersfield, CA 93309-4817
Phone (661) 835-5811
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
| License | State | Type | Specialty |
|---|---|---|---|
| 56057 | CA | MD | Hospice and Palliative Medicine (Internal Medicine) Physician |
Interoperability endpoints
- lku@direct.westerndental.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1270857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1389139200000",
"number": "1023334489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4409 MING AVE",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933094817",
"telephone_number": "661-835-5811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4409 MING AVE",
"city": "BAKERSFIELD",
"state": "CA",
"postal_code": "933094817",
"telephone_number": "661-835-5811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "LISA",
"middle_name": "KU",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-10",
"last_updated": "2014-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "CA",
"license": "56057",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bakersfield, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.