Chang & Phan Dental, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

14020 Issued in MD

Legal business name

CHANG & PHAN DENTAL, LLC

Doing business as

All Star Pediatric Dentistry

Practice address

451 Hungerford Dr Ste 100
Rockville, MD 20850-5102

Phone

(240) 381-7814

NPI assigned

Aug 2, 2018

Last updated

Aug 2, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Carolyn Soojin Chang, DMDNPI 1881859148

Title

Managing Member

Phone

(240) 381-7814

Specialties & licenses 1

Addresses

Other names 1

• All Star Pediatric Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Carolyn Soojin Chang, DMD

  • General Practice Dentistry
  • Glen Burnie, MD
  • NPI 1881859148

  Pediatric Dentistry

  NPD (past) Authorized official

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

{
    "created_epoch": "1533168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1533168000000",
    "number": "1083192884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3517 DOC BERLIN DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209061151",
            "telephone_number": "240-381-7814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 HUNGERFORD DR STE 100",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208505102",
            "telephone_number": "240-381-7814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANG & PHAN DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-02",
        "last_updated": "2018-08-02",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "CAROLYN",
        "authorized_official_middle_name": "SOOJIN",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "240-381-7814",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "14020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "All Star Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "All Star Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kimberly Marie Chandler, PT
• Rene Chandler, LGSW
• Ravi Anant Chandra, MD, PHD
• Gabriella Chaney
• Marlo Chaney
• Angela Heajung Chang, LMSW
• Angela Lee Chang, DPT
• Betty Chang
• Elbert Chang, DDS, MS
• Frank Edgar Chang, M.D.

• Pediatric Dentistry in Rockville, MD
• Providers in Rockville, MD by specialty
• Pediatric Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; 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.