Active NPI
Seung H Chang
- Prosthodontics
- Medford, MA
National Provider Identifier
1821151853
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthodontics
- License
- 21063
- Practice address
- 616 Fellsway Ste 2
Medford, MA 02155-4957 - Phone
- (781) 306-9644
- Fax
- (781) 306-9726
- NPI assigned
- Dec 19, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthodontics | 1223P0700X | 21063 | MA | Primary |
Addresses
Primary practice location
616 Fellsway Ste 2
Medford, MA 02155-4957
Mailing address
616 Fellsway Ste 2
Medford, MA 02155-4957
Phone (781) 306-9644
Other names 1
- John Chang
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 |
|---|---|---|---|
| 21063 | MA | MD | Prosthodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1821151853",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "616 FELLSWAY STE 2",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021554957",
"telephone_number": "781-306-9644",
"fax_number": "781-306-9726"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "616 FELLSWAY STE 2",
"city": "MEDFORD",
"state": "MA",
"postal_code": "021554957",
"telephone_number": "781-306-9644",
"fax_number": "781-306-9726"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "SEUNG",
"middle_name": "H",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0700X",
"taxonomy_group": "",
"desc": "Dentist, Prosthodontics",
"state": "MA",
"license": "21063",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "JOHN",
"last_name": "CHANG",
"credential": "DMD, MMSC",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Medford, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.