Ivy Chang, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DI01992300 Issued in NJ

Practice address

669 Westwood Ave
River Vale, NJ 07675-6336

Phone

(201) 664-0130

NPI assigned

Mar 8, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1268006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1644364800000",
    "number": "1447573241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "669 WESTWOOD AVE",
            "city": "RIVER VALE",
            "state": "NJ",
            "postal_code": "076756336",
            "telephone_number": "201-666-7555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "669 WESTWOOD AVE",
            "city": "RIVER VALE",
            "state": "NJ",
            "postal_code": "076756336",
            "telephone_number": "201-664-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "IVY",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-08",
        "last_updated": "2022-02-09",
        "certification_date": "2022-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "046700",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI19923",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NJ",
            "license": "DI01992300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Buldo-Licciardi
• Kristen Burns, NP
• Alexandra Lauren Caminneci
• Frank M Candido, MD
• April Capawana, LCSW
• Vincent Chisari, COTA/L
• Edith Y Chiu
• Amy Dahl, RD
• Donna J Ferraro MD
• Marianne Grace Dunn, PHD

• All providers in River Vale, NJ
• General Practice Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.