Organization Active NPI

Wunderlich & Chang DDS, Ms, PC

  • Periodontics
  • Canton, MI
National Provider Identifier
1194975276
Registry record updated Sep 24, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
Legal business name
WUNDERLICH & CHANG DDS, MS, PC
Practice address
42301 Cherry Hill Rd
Suite a
Canton, MI 48188-9801
Phone
(734) 981-7477
Fax
(734) 981-0328
NPI assigned
Sep 24, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 24, 2008

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

Authorized official

Name
Dr. Richard C Wunderlilch, DDS, MS
Title
President
Phone
(734) 981-7474

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PeriodonticsGroup: 193400000X SINGLE SPECIALTY GROUP 1223P0300X Primary

Addresses

Primary practice location

42301 Cherry Hill Rd
Suite a
Canton, MI 48188-9801

Mailing address

42301 Cherry Hill Rd
Suite a
Canton, MI 48188-9801
Phone (734) 981-7477

Other identifiers 1

IdentifierTypeStateIssuer
J800274OtherMIBLUE CROSS BLUE SHIELD

National Provider Directory

National Provider Directory

Locations

42301 Cherry Hill Rd
Ste A
Canton, MI 48188
Phone (734) 981-7477

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1222214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1222214400000",
    "number": "1194975276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42301 CHERRY HILL RD",
            "address_2": "SUITE A",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481889801",
            "telephone_number": "734-981-7477",
            "fax_number": "734-981-0328"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42301 CHERRY HILL RD",
            "address_2": "SUITE A",
            "city": "CANTON",
            "state": "MI",
            "postal_code": "481889801",
            "telephone_number": "734-981-7477",
            "fax_number": "734-981-0328"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WUNDERLICH & CHANG DDS, MS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-24",
        "last_updated": "2008-09-24",
        "status": "A",
        "authorized_official_last_name": "WUNDERLILCH",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "734-981-7474",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS, MS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "J800274",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2008; 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.