Jim S Chang, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

34942 Issued in CA

Practice address

12798 Rancho Penasquitos Blvd # 1
San Diego, CA 92129

Phone

(858) 484-9776

Fax

(858) 484-0721

NPI assigned

May 5, 2014

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1399248000000",
    "number": "1184034746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12798 RANCHO PENASQUITOS BLVD # 1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92129",
            "telephone_number": "858-484-9776",
            "fax_number": "858-484-0721"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12798 RANCHO PENASQUITOS BLVD # 1",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92129",
            "telephone_number": "858-484-9776",
            "fax_number": "858-484-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JIM",
        "middle_name": "S",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-05",
        "last_updated": "2014-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "34942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Chang, MD
• Jennifer N Chang, PHARMD
• Jeremy Scott Chang, M.D.
• Jessica Chang, CRNA
• Jill Chang, PA-C
• Johanna CHI Chang, M.D.
• John Tzu-Yu Chang, MD
• Julie Chang, L.AC.
• Kai-Chiao Joe Chang, D.D.S.
• Katherine Chang

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2014; 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.