Individual provider Active NPI

Kristy Chang

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1396477253
Registry record updated Feb 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
107552 Issued in CA
Practice address
6000 N Figueroa St
Los Angeles, CA 90042-4232
Phone
(626) 381-8700
NPI assigned
Jun 29, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 107552 CA Primary

Addresses

Primary practice location

6000 N Figueroa St
Los Angeles, CA 90042-4232

Mailing address

849 N Bunker Hill Ave.
#201
Los Angeles, CA 90012
Phone (626) 381-8700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20221110001712 CA Practitioner - Dentist 9537536180 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
107552CAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Arroyo Vista Family Health Foundation CurrentSince Sep 1, 2022 Accepting new patients
Arroyo Vista Family Health Foundation CurrentSince Sep 1, 2022 Accepting new patients

Locations

6000 N Figueroa St
Los Angeles, CA 90042
Phone (323) 254-5221

Interoperability endpoints

  • Direct secure messaging: kristy.chang.p1@direct.arroyovista.nextgenshare.com
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: kchang704679@direct.ochin.org

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1656460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675641600000",
    "number": "1396477253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "849 N BUNKER HILL AVE.",
            "address_2": "#201",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90012",
            "telephone_number": "626-381-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6000 N FIGUEROA ST",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900424232",
            "telephone_number": "626-381-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "KRISTY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-29",
        "last_updated": "2023-02-06",
        "certification_date": "2023-01-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "107552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.