Nancy Su-Fang Chang, D.M.D.
Individual provider Active NPI Pediatric Dentistry · Superior, CO
NPI 1124257936 · NPPES record last updated Mar 17, 2018
Key facts
- NPI
- 1124257936
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Dentistry 1223P0221X
- License
- DEN.00203199 (CO)
- Practice address
- 306 Center Dr
Superior, CO 80027-8625 - Phone
- (303) 499-9555
- NPI assigned
- Jul 14, 2009
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0401412728 | VA | MD | General Practice Dentistry |
| DEN.00203199 | CO | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Richard S Schneider DDS PC | General Practice | Past | Accepting new patients |
| Marketplace Dental Group and Orthodontics, LLP | General Practice | Past | Accepting new patients |
| Susana Raygada D.M.D., P.C. | General Practice | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 0401412728 | VA | |
| Pediatric Dentistry | 1223P0221X | DEN.00203199 | CO | Yes |
Addresses
Primary practice location
306 Center Dr
Superior, CO 80027-8625
Mailing address
306 Center Dr
Superior, CO 80027-8625
Other practice location 1
5211 Lyngate Court
Burke, VA 22015
Phone (703) 323-1400
Other providers in Superior, CO
- Samantha Carloto
- Tara Carine Carlson
- Kimberly Carter
- Linda J Cevaal
- Marcie Chambers
- Chriesl Infusion Centers LLC
- Chanise Christopher
- Roger F Cohen
- Suzy Cohen
- Amber A Cole
All providers in Superior, CO · Pediatric Dentistry in Colorado
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.