Individual provider Active NPI

Sean Chang

  • Dentist
  • Irvine, CA
National Provider Identifier
1588045124
Registry record updated Jan 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
101318 Issued in CA
Practice address
4902 Irvine Center Dr Ste 200
Irvine, CA 92604-3335
Phone
(949) 733-8011
NPI assigned
Jun 9, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 101318 CA Primary

Addresses

Primary practice location

4902 Irvine Center Dr Ste 200
Irvine, CA 92604-3335

Mailing address

2284 Synergy # 615
Irvine, CA 92614-0167
Phone (310) 686-9442

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
101318CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Sean Wonhyung Chang PastSince Sep 29, 2019 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.

NPI Registry JSON

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

{
    "created_epoch": "1433808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547078400000",
    "number": "1588045124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2284 SYNERGY # 615",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926140167",
            "telephone_number": "310-686-9442"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4902 IRVINE CENTER DR STE 200",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926043335",
            "telephone_number": "949-733-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "SEAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-09",
        "last_updated": "2019-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "101318",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Irvine, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2019; 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.