Glenn Chang DDS Inc

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

54537 Issued in CA

Legal business name

GLENN CHANG DDS INC

Practice address

20657 Golden Springs Dr
Suite205B
Diamond Bar, CA 91789-3875

Phone

(909) 595-2868

Fax

(909) 569-1866

NPI assigned

Sep 30, 2014

Organization subpart

No

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

Authorized official

Name

Glenn Chang, DDS

Title

President

Phone

(909) 595-2868

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1412035200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413331200000",
    "number": "1396148771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20657 GOLDEN SPRINGS DR",
            "address_2": "SUITE205B",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917893875",
            "telephone_number": "909-595-2868",
            "fax_number": "909-569-1866"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20657 GOLDEN SPRINGS DR",
            "address_2": "SUITE205B",
            "city": "DIAMOND BAR",
            "state": "CA",
            "postal_code": "917893875",
            "telephone_number": "909-595-2868",
            "fax_number": "909-569-1866"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GLENN CHANG DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-30",
        "last_updated": "2014-10-15",
        "status": "A",
        "authorized_official_last_name": "CHANG",
        "authorized_official_first_name": "GLENN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "909-595-2868",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "54537",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina K Georgescu
• Patricia Danielah Germon, MA
• Kunal Ghosh
• Sangram Gill
• Alyssa M Givehand
• Kevin Scott Glenn, D.C.,DABCO
• Global Mother Care Group Inc
• Golden Springs Pharmacy Inc.
• Gong Pharmacist Professional Corporation
• Veronica Angelina Gonzalez

• Periodontics in Diamond Bar, CA
• Providers in Diamond Bar, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; 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.