Active NPI
Kevin Chun Hui Chang, DDS
- Dentist
- Espanola, NM
National Provider Identifier
1861005662
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DD5314
- Practice address
- 1508 N Riverside Dr
Espanola, NM 87532-2064 - Phone
- (505) 753-0544
- NPI assigned
- Aug 31, 2020
- Last updated
- Aug 31, 2020
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | DD5314 | NM | Primary |
Addresses
Primary practice location
1508 N Riverside Dr
Espanola, NM 87532-2064
Mailing address
160 Morgan St Apt 509
Jersey City, NJ 07302-6243
Phone (617) 710-4387
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 |
|---|---|---|---|
| DD5314 | NM | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Daybreak Associates PLLC | Current | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Dental Clinic/Center
- Austin, TX
- NPI 1811777667
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1598832000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1598832000000",
"number": "1861005662",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 MORGAN ST APT 509",
"city": "JERSEY CITY",
"state": "NJ",
"postal_code": "073026243",
"telephone_number": "617-710-4387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1508 N RIVERSIDE DR",
"city": "ESPANOLA",
"state": "NM",
"postal_code": "875322064",
"telephone_number": "505-753-0544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHANG",
"first_name": "KEVIN",
"middle_name": "CHUN HUI",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-08-31",
"last_updated": "2020-08-31",
"certification_date": "2020-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NM",
"license": "DD5314",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Espanola, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.