Individual provider Active NPI

Yu-Chien Chang, DDS

  • Dentist
  • Fresh Meadows, NY
National Provider Identifier
1265698021
Registry record updated Oct 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
050450 Issued in NY
Practice address
19216 50TH Ave
Fresh Meadows, NY 11365-1204
Phone
(917) 575-6657
Fax
(718) 457-2501
NPI assigned
Jul 31, 2008
Last updated
Oct 13, 2009By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02256600 NJ
Dentist 122300000X 050450 NY Primary

Addresses

Primary practice location

19216 50TH Ave
Fresh Meadows, NY 11365-1204

Mailing address

8616 Queens Blvd
Suite 203
Elmhurst, NY 11373-4433
Phone (718) 457-8787

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20181116000740 NY Order and Referring Only - DentistPractitioner - Dentist 5294089926

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02256600NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
JZ Dental, PC Past 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": "1217462400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1255392000000",
    "number": "1265698021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8616 QUEENS BLVD",
            "address_2": "SUITE 203",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113734433",
            "telephone_number": "718-457-8787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19216 50TH AVE",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651204",
            "telephone_number": "917-575-6657",
            "fax_number": "718-457-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "YU-CHIEN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-31",
        "last_updated": "2009-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02256600",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "050450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresh Meadows, NY

Sources for this page

Verify at the official NPI Registry.