Active NPI
John William KM Chang, DDS
- Pediatric Dentistry
- Mililani, HI
National Provider Identifier
1518307610
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DT-2543
- Practice address
- 95-1105 Ainamakua Dr
Ste #202
Mililani, HI 96789-6313 - Phone
- (808) 445-6272
- Fax
- (808) 495-0582
- NPI assigned
- Jul 3, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 2013022282 | MO | |
| Pediatric Dentistry | 1223P0221X | DT-2543 | HI | Primary |
Addresses
Primary practice location
95-1105 Ainamakua Dr
Ste #202
Mililani, HI 96789-6313
Mailing address
95-1105 Ainamakua Dr
Ste #202
Mililani, HI 96789-6313
Phone (808) 445-6272
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 |
|---|---|---|---|
| 2013022282 | MO | MD | Dentist |
| DT-2543 | HI | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Honu Smiles Pediatric Dentistry | Pediatric Dentistry | 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.
-
- Pediatric Dentistry
- Mililani, HI
- NPI 1144766486
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1372809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1494201600000",
"number": "1518307610",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "95-1105 AINAMAKUA DR",
"address_2": "STE #202",
"city": "MILILANI",
"state": "HI",
"postal_code": "967896313",
"telephone_number": "808-445-6272",
"fax_number": "808-495-0582"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95-1105 AINAMAKUA DR",
"address_2": "STE #202",
"city": "MILILANI",
"state": "HI",
"postal_code": "967896313",
"telephone_number": "808-445-6272",
"fax_number": "808-495-0582"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "JOHN WILLIAM",
"middle_name": "KM",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-07-03",
"last_updated": "2017-05-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MO",
"license": "2013022282",
"primary": false
},
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "HI",
"license": "DT-2543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mililani, HI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.