Carolyn Soojin Chang, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN1000721 Issued in DC

Practice address

7671 Quarterfield Rd Ste 400
Glen Burnie, MD 21061

Phone

(410) 760-1212

NPI assigned

Jul 25, 2008

Sex

Female

Sole proprietor

Yes

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

Practice roles

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.

• Chang & Phan Dental, LLC

  • Pediatric Dentistry
  • Rockville, MD
  • NPI 1083192884
  NPD (past) Authorized official
• Pediatric Dentistry and Orthodontics of Maryland LLC

  • Pediatric Dentistry
  • Glen Burnie, MD
  • NPI 1427169085
  NPD (past)

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

{
    "created_epoch": "1216944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532217600000",
    "number": "1881859148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3517 DOC BERLIN DR",
            "city": "SILVER SPRING",
            "state": "MD",
            "postal_code": "209061151",
            "telephone_number": "240-381-7814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7671 QUARTERFIELD RD STE 400",
            "city": "GLEN BURNIE",
            "state": "MD",
            "postal_code": "21061",
            "telephone_number": "410-760-1212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "CAROLYN",
        "middle_name": "SOOJIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-07-25",
        "last_updated": "2018-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MD",
            "license": "14020",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "DC",
            "license": "DEN1000721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Polly Chace
• Gila Chamama, LGPC
• Lanitra Chambers
• Vonda Faye Chaney, MD
• Alice E Chang, MD
• Soyoung Monica Chang, PHARMD
• Channeling Your Strength
• Samantha Chao, RBT
• Niemah L Chapman, CRNP
• Katelyn Anne Charest

• General Practice Dentistry in Glen Burnie, MD
• Providers in Glen Burnie, MD by specialty
• General Practice Dentistry in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2018; 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.