Dillon Chang, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

DE61303625 Issued in WA

Practice address

10725 SE 256TH St Ste 1
Kent, WA 98030-8285

Phone

(253) 854-2714

NPI assigned

Apr 8, 2021

Reactivated

Jul 1, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Dhaliwal and Dhaliwal DDS, PLLC

  • General Practice Dentistry
  • Covington, WA
  • NPI 1144928276
  NPD
• Dhaliwal, DDS, PLLC

  • General Practice Dentistry
  • Kent, WA
  • NPI 1750834883
  NPD (past)

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656720000000",
    "number": "1356920060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1232 RIDGE AVE UNIT 301",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191233390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10725 SE 256TH ST STE 1",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980308285",
            "telephone_number": "253-854-2714"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "DILLON",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-08",
        "last_updated": "2022-07-02",
        "certification_date": "2022-07-02",
        "deactivation_date": "2022-04-22",
        "reactivation_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61303625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jenny S Chai
• Chisula Chambers, MPH, LPN
• Michelle Chan, OD
• Radhika Prasad Chand, BA
• Sherlin Chandra, RN
• Von Chang, MD
• Changes and Empowerment Programs
• Charanjit K. Lamba M.D. P.S.
• Noa Lindsay Chargualaf
• Genienne Charvet

• Dentist in Kent, WA
• Providers in Kent, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2022; 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.