Individual provider Active NPI

Chung-Ming Chang-Chien, D.D.S.

  • General Practice Dentistry
  • Somerville, MA
National Provider Identifier
1124172531
Registry record updated Mar 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
18417 Issued in MA
Practice address
593 McGrath Hwy
Somerville, MA 02145-3138
Phone
(617) 623-1656
Fax
(617) 623-7576
NPI assigned
Jan 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 22, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 18417 MA Primary
General Practice Dentistry 1223G0001X 3372 NH

Addresses

Primary practice location

593 McGrath Hwy
Somerville, MA 02145-3138

Mailing address

593 McGrath Hwy
Somerville, MA 02145-3138
Phone (617) 623-1656

Other identifiers 1

IdentifierTypeStateIssuer
3073216MedicaidNH

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161018001988 MA Order and Referring Only - DentistPractitioner - Dentist 6406144880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
3372NHMDGeneral Practice Dentistry
18417MAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490140800000",
    "number": "1124172531",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "593 MCGRATH HWY",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021453138",
            "telephone_number": "617-623-1656",
            "fax_number": "617-623-7576"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 MCGRATH HWY",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "021453138",
            "telephone_number": "617-623-1656",
            "fax_number": "617-623-7576"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG-CHIEN",
        "first_name": "CHUNG-MING",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2017-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "18417",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NH",
            "license": "3372",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3073216",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

Verify at the official NPI Registry.