Individual provider Active NPI

Derek Chang

  • General Practice Dentistry
  • San Francisco, CA
National Provider Identifier
1356254981
Registry record updated Sep 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
113634 Issued in CA
Practice address
345 W Portal Ave Ste 210
San Francisco, CA 94127-1429
Phone
(415) 681-1011
NPI assigned
Sep 24, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2026

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 113634 CA Primary

Addresses

Primary practice location

345 W Portal Ave Ste 210
San Francisco, CA 94127-1429

Mailing address

345 W Portal Ave Ste 210
San Francisco, CA 94127-1429
Phone (415) 681-1011

Medicare participation

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

NPI Registry JSON

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

{
    "created_epoch": "1790208000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790294400000",
    "number": "1356254981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 W PORTAL AVE STE 210",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941271429",
            "telephone_number": "415-681-1011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "345 W PORTAL AVE STE 210",
            "city": "SAN FRANCISCO",
            "state": "CA",
            "postal_code": "941271429",
            "telephone_number": "415-681-1011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "DEREK",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-09-24",
        "last_updated": "2026-09-25",
        "certification_date": "2026-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "113634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Francisco, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.