Individual provider Active NPI

Jiachang Zhang, D.D.S

  • Oral and Maxillofacial Surgery (Dentist)
  • Encinitas, CA
National Provider Identifier
1578649604
Registry record updated Aug 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
50552 Issued in CA
Practice address
511 Encinitas Blvd Ste 118
Encinitas, CA 92024-3781
Phone
(760) 392-1279
NPI assigned
Oct 31, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 11, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 50552 CA
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 50552 CA Primary

Addresses

Primary practice location

511 Encinitas Blvd Ste 118
Encinitas, CA 92024-3781

Mailing address

135 S Hidden Path
Anaheim, CA 92801-5149
Phone (714) 999-0499

Other identifiers 1

IdentifierTypeStateIssuer
B50552-01OtherCAHEALTHY FAMILY

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
I20200420001733 CA Practitioner - Oral SurgeryPractitioner - Dentist 8325478175 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Maria T Alarcon DDS Dental Corporation CurrentSince May 27, 2022 Accepting new patients
Dr. Jiachang Zhang, Inc. Oral and Maxillofacial Surgery CurrentSince Sep 1, 2015 Accepting new patients

Locations

511 Encinitas Blvd
Ste 118
Encinitas, CA 92024
Phone (760) 392-1279

19682 Hesperian Blvd
Ste 106
Hayward Acres, CA 94541
Phone (510) 252-4003

19682 Hesperian Blvd
Ste 208
Hayward Acres, CA 94541
Phone (510) 253-2350

3927 Macdonald Ave
Richmond, CA 94805
Phone (510) 232-4003

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1162252800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660176000000",
    "number": "1578649604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 S HIDDEN PATH",
            "city": "ANAHEIM",
            "state": "CA",
            "postal_code": "928015149",
            "telephone_number": "714-999-0499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 ENCINITAS BLVD STE 118",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920243781",
            "telephone_number": "760-392-1279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ZHANG",
        "first_name": "JIACHANG",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-31",
        "last_updated": "2022-08-11",
        "certification_date": "2022-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "50552",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "50552",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHY FAMILY",
            "identifier": "B50552-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Encinitas, CA

Sources for this page

Verify at the official NPI Registry.