Individual provider Active NPI

Emily B Chang, DDS

  • Dentist
  • Somerville, MA
National Provider Identifier
1487707030
Registry record updated Feb 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
21812 Issued in MA
Practice address
474 Broadway
Suite 110
Somerville, MA 02145
Phone
(617) 623-2223
Fax
(617) 623-2333
NPI assigned
Jan 18, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 46765 CA
Dentist 122300000X 21812 MA Primary

Addresses

Primary practice location

474 Broadway
Suite 110
Somerville, MA 02145

Mailing address

474 Broadway
Suite 110
Somerville, MA 02145
Phone (617) 623-2223

Other practice location 1

4 Embarcadero Ctr
Embarcadero 4 Dental, Lobby Level
San Francisco, CA 94111-5900
Phone (415) 576-9800

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

LicenseStateTypeSpecialty
46765CAMDDentist
21812MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614124800000",
    "number": "1487707030",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "474 BROADWAY",
            "address_2": "SUITE 110",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "02145",
            "telephone_number": "617-623-2223",
            "fax_number": "617-623-2333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "474 BROADWAY",
            "address_2": "SUITE 110",
            "city": "SOMERVILLE",
            "state": "MA",
            "postal_code": "02145",
            "telephone_number": "617-623-2223",
            "fax_number": "617-623-2333"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4 Embarcadero Ctr",
            "address_2": "Embarcadero 4 Dental, Lobby Level",
            "address_purpose": "LOCATION",
            "city": "San Francisco",
            "state": "CA",
            "postal_code": "941115900",
            "country_code": "US",
            "telephone_number": "415-576-9800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "EMILY",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2021-02-24",
        "certification_date": "2021-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "46765",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "21812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Somerville, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2021; 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.