Evan Y Chang, DDS Inc

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

EVAN Y CHANG, DDS INC

Doing business as

Primary Teeth Pediatric Dentistry

Practice address

3085 Telegraph Ave
Berkeley, CA 94705-2035

Phone

(510) 984-1768

Fax

(510) 984-1769

NPI assigned

Mar 19, 2024

Organization subpart

No

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

Authorized official

Name

Dr. Evan Y Chang, DDSNPI 1699127266

Title

Ceo

Phone

(310) 938-0423

Specialties & licenses 1

Addresses

Other names 1

• Primary Teeth Pediatric Dentistry Doing business as

Practitioners 1

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

• Evan Y Chang, DDS

  • Pediatric Dentistry
  • Berkeley, CA
  • NPI 1699127266
  NPD Authorized official

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

{
    "created_epoch": "1710806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710806400000",
    "number": "1124888144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1844 MARKET ST UNIT 208",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941026288",
            "telephone_number": "310-938-0423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3085 TELEGRAPH AVE",
            "city": "BERKELEY",
            "state": "CA",
            "postal_code": "947052035",
            "telephone_number": "510-984-1768",
            "fax_number": "510-984-1769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EVAN Y CHANG, DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-19",
        "last_updated": "2024-03-19",
        "certification_date": "2024-03-19",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "EVAN",
        "authorized_official_middle_name": "Y",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "310-938-0423",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Primary Teeth Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sandra Esquivel, LMFT
• Aysiah Estores
• Jason Etchingham
• Zalae Olysia Etienne, MS, RDN
• Ev Marriage and Family Therapy, Inc.
• Joann Evangelista
• Gayathri Sai Evani
• Juliana Evans-Anfom, DPT
• Tracy M. Evans-Ramsey, M.D.
• William Todd Evans

• Pediatric Dentistry in Berkeley, CA
• Providers in Berkeley, CA by specialty
• Pediatric Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2024; 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.