Individual provider Active NPI

David Joey Chang, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Boston, MA
National Provider Identifier
1083879829
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
22220 Issued in MA
Practice address
800 Washington St
Boston, MA 02111-1552
Phone
(617) 636-6712
Fax
(617) 636-6809
NPI assigned
Jul 22, 2008
Last updated
Nov 13, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 22220 MA Primary

Addresses

Primary practice location

800 Washington St
Boston, MA 02111-1552

Mailing address

1 Kneeland St
RM 506
Boston, MA 02111-1527
Phone (617) 636-6712

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160726002875 MA Practitioner - Maxillofacial SurgeryPractitioner - Oral Surgery 7113210246 Reassigns benefits to 2 organizations
Practice locations: Boston, MA

Care Compare profile

Medicare Care Compare
Specialty
Maxillofacial SurgeryAlso: Oral Surgery
Education
Tufts University School of Dental Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Trustees of Tufts CollegeGroup PAC ID 3779522628, 15 clinicians
Salem-Peabody Oral Surgery IncGroup PAC ID 6204927700, 4 clinicians

Practice addresses (Care Compare)

1 Kneeland St
Boston, MA 02111-1527
Phone (617) 636-6828

6 Essex Ctr Dr
Suite 112a
Peabody, MA 01960-2905
Phone (781) 323-4345

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22220MAMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Trustees of Tufts College CurrentSince Feb 18, 2019 Accepting new patients
Salem Peabody Oral Surgery Inc. Oral and Maxillofacial Surgery CurrentSince Jun 1, 2024 Accepting new patients
Trustees of Tufts College CurrentSince Feb 18, 2019 Accepting new patients

Locations

1 Kneeland St
Boston, MA 02111
Phone (617) 636-6515

1 Kneeland St
Fl 12
Boston, MA 02111
Phone (617) 636-6531

1 Kneeland St
Fl 3
Boston, MA 02111
Phone (617) 636-6669

1 Kneeland St
Fl 5
Boston, MA 02111
Phone (617) 636-6515

1 Kneeland St
Rm 506
Boston, MA 02111
Phone (617) 636-3932

6 Essex Center Dr
Ste 112A
Peabody, MA 01960
Phone (781) 323-4345

Interoperability endpoints

  • Direct secure messaging: dchang29404@tuftsmedicine.direct-ci.com

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1083879829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KNEELAND ST",
            "address_2": "RM 506",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111527",
            "telephone_number": "617-636-6712",
            "fax_number": "617-636-6809"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-6712",
            "fax_number": "617-636-6809"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "DAVID",
        "middle_name": "JOEY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-22",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "22220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.