Jim S Chang DDS Inc

Primary specialty

DentistTaxonomy code 122300000X

License

34942 Issued in CA

Legal business name

JIM S CHANG DDS INC

Doing business as

Penasquitos Point Family Dentristry

Practice address

12798 Ranch Penasquitos Blvd
Suite I
San Diego, CA 92129

Phone

(858) 484-9776

Fax

(858) 484-0721

NPI assigned

Aug 24, 2006

Organization subpart

No

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

Authorized official

Name

Jim S Chang, DDS

Title

Ceo

Phone

(858) 484-9776

Specialties & licenses 1

Addresses

Other names 1

• Penasquitos Point Family Dentristry Doing business as

Practitioners 1

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

• Helen Hong Yang, D.D.S.

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1306897228
  NPD (past)

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1306953690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12798 RANCH PENASQUITOS BLVD",
            "address_2": "SUITE I",
            "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 RANCH PENASQUITOS BLVD",
            "address_2": "SUITE I",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92129",
            "telephone_number": "858-484-9776",
            "fax_number": "858-484-0721"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIM S CHANG DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "JIM",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "858-484-9776",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "34942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Penasquitos Point Family Dentristry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kifle Gashie Jikamo
• Jill Boyle, Marriage and Family Therapist, Inc
• Jill S Meoni
• Amy Alyssa Jillson
• Jim Hatton, PH.D, Marriage and Family Therapist, Apc
• Jim W. Turnage MD Professional Corp
• Adria Jimenez Bacardi, MD
• Stephanie Jimenez Batista
• Melina Andrei Jimenez Celaya
• Roberto Jimenez Espana

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.