Paul C Chang Dental Inc

Primary specialty

DentistTaxonomy code 122300000X

License

32540 Issued in CA

Legal business name

PAUL C CHANG DENTAL INC

Practice address

600 N Mountain Ave
#D 205
Upland, CA 91786

Phone

(909) 985-9866

Fax

(909) 931-0908

NPI assigned

Sep 7, 2006

Organization subpart

No

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

Authorized official

Name

Paul C Chang, DDSNPI 1760698914

Title

Dentist

Phone

(909) 985-9866

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Paul C. Chang, DDS

  • Dentist
  • Upland, CA
  • NPI 1760698914
  NPD (past) Authorized official

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

{
    "created_epoch": "1157587200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073617445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 N MOUNTAIN AVE",
            "address_2": "#D 205",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-985-9866",
            "fax_number": "909-931-0908"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 N MOUNTAIN AVE",
            "address_2": "#D 205",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-985-9866",
            "fax_number": "909-931-0908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PAUL C CHANG DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "909-985-9866",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "32540",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTI CAL",
            "identifier": "B3254002",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Sheerali Patel, PHARM.D.
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• Patricia M Jenkins DC a Professional Chiropractic Corp
• Jenniflor Paulo
• Lauryn Paz
• Pediatric Adolescent Clinic
• Maritza Pelayo
• Lisa Marie Penaloza

• Dentist in Upland, CA
• Providers in Upland, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.