Active NPI
Jason C Chang, D.M.D.M.S.
- Periodontics
- New York, NY
National Provider Identifier
1417019381
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 22DI02039500
- Practice address
- 180 Park Row
New York, NY 10038-1127 - Phone
- (212) 385-9399
- NPI assigned
- Dec 15, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 22DI02039500 | NJ | Primary |
Addresses
Primary practice location
180 Park Row
New York, NY 10038-1127
Mailing address
180 Park Row
New York, NY 10038-1127
Phone (212) 385-9399
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI02039500 | NJ | MD | Periodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Chatham Tower Dental Office P.C. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- General Practice Dentistry
- New York, NY
- NPI 1598983512
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1417019381",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "180 PARK ROW",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100381127",
"telephone_number": "212-385-9399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 PARK ROW",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100381127",
"telephone_number": "212-385-9399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "JASON",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "D.M.D.M.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-15",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NJ",
"license": "22DI02039500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.