Jessica Chang

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

062079-01 Issued in NY

Practice address

1400 Pelham Pkwy S
Bronx, NY 10461-1197

Phone

(718) 918-3419

NPI assigned

Mar 19, 2020

Last updated

Jan 6, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

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": "1584576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1588290746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 E 84TH ST APT 7D",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100282960",
            "telephone_number": "650-868-1201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 PELHAM PKWY S",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104611197",
            "telephone_number": "718-918-3419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "JESSICA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-03-19",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "062079-01",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diane Chang, MD
• Gloria Chang, DDS
• Jeemin Chang, DMD
• Jennifer Wei Chang, D.D.S
• Jenny Chang
• Ji-Ae Joanna Chang, LCSW
• John Chang
• Jong Moon Chang, M.D.
• Judy H Chang, DDS
• Kai-Ming Chang, MD

• General Practice Dentistry in Bronx, NY
• Providers in Bronx, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.