Individual provider Active NPI

Irene Dan Yi Chang

  • Dentist
  • Honolulu, HI
National Provider Identifier
1225662026
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DT-3037 Issued in HI
Practice address
500 Ala Moana Blvd Ste 7300
Honolulu, HI 96813-4905
Phone
(808) 523-4332
NPI assigned
Mar 2, 2020
Last updated
Oct 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
General Practice Dentistry 1223G0001X 106907 CA
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X DT-3037 HI Primary

Addresses

Primary practice location

500 Ala Moana Blvd Ste 7300
Honolulu, HI 96813-4905

Mailing address

1778 Ala Moana Blvd Apt 3815
Honolulu, HI 96815-1627
Phone (408) 691-3579

Other practice location 1

2239 N School St
Honolulu, HI 96819-2539
Phone (808) 791-9400

Other practice location 2

10251 Torre Ave Ste 138
Cupertino, CA 95014-2184
Phone (408) 996-9865

Other practice location 3

1299 Water Lily Way Ste 50
San Jose, CA 95129-2868
Phone (408) 996-2468

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DT-3037HIMDDentist
106907CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Chang Dental Corporation General Practice PastSince Oct 1, 2021 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1583107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1225662026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1778 ALA MOANA BLVD APT 3815",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968151627",
            "telephone_number": "408-691-3579"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 ALA MOANA BLVD STE 7300",
            "city": "HONOLULU",
            "state": "HI",
            "postal_code": "968134905",
            "telephone_number": "808-523-4332"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2239 N School St",
            "address_purpose": "LOCATION",
            "city": "Honolulu",
            "state": "HI",
            "postal_code": "968192539",
            "country_code": "US",
            "telephone_number": "808-791-9400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10251 Torre Ave Ste 138",
            "address_purpose": "LOCATION",
            "city": "Cupertino",
            "state": "CA",
            "postal_code": "950142184",
            "country_code": "US",
            "telephone_number": "408-996-9865",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1299 Water Lily Way Ste 50",
            "address_purpose": "LOCATION",
            "city": "San Jose",
            "state": "CA",
            "postal_code": "951292868",
            "country_code": "US",
            "telephone_number": "408-996-2468",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "IRENE",
        "middle_name": "DAN YI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106907",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "HI",
            "license": "DT-3037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Honolulu, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 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.