Individual provider Active NPI

Cher Y Chang, DMD

  • General Practice Dentistry
  • Las Vegas, NV
National Provider Identifier
1255419420
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4862 Issued in NV
Practice address
4415 Spring Mountain Rd Ste 103
Las Vegas, NV 89102-8758
Phone
(702) 307-5414
Fax
(702) 307-5421
NPI assigned
Nov 2, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4862 NV Primary

Addresses

Primary practice location

4415 Spring Mountain Rd Ste 103
Las Vegas, NV 89102-8758

Mailing address

4415 Spring Mountain Rd Ste 103
Las Vegas, NV 89102-8758
Phone (702) 307-5414

Other identifiers 1

IdentifierTypeStateIssuer
4862OtherNVDENTAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NV
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160108000302 NV Order and Referring Only - DentistPractitioner - Dentist 5698088532

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4862NVMDFamily Medicine Physician

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255419420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4415 SPRING MOUNTAIN RD STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891028758",
            "telephone_number": "702-307-5414",
            "fax_number": "702-307-5421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4415 SPRING MOUNTAIN RD STE 103",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891028758",
            "telephone_number": "702-307-5414",
            "fax_number": "702-307-5421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "CHER",
        "middle_name": "Y",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "4862",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "4862",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

Verify at the official NPI Registry.