Priscilla Pauline Chang, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019027336 Issued in IL

Practice address

80 N Northwest Hwy
Park Ridge, IL 60068-3329

Phone

(847) 292-0600

Fax

(847) 292-0608

NPI assigned

Dec 4, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective May 4, 2016 through May 4, 2028

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.

• Ruttencutter Chang, PC

  • Dentist
  • Park Ridge, IL
  • NPI 1275828360
  NPD (past)

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

{
    "created_epoch": "1196726400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1335312000000",
    "number": "1922280643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 N NORTHWEST HWY",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600683329",
            "telephone_number": "847-292-0600",
            "fax_number": "847-262-0608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 N NORTHWEST HWY",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600683329",
            "telephone_number": "847-292-0600",
            "fax_number": "847-292-0608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "PRISCILLA",
        "middle_name": "PAULINE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-04",
        "last_updated": "2012-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019027336",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christy Chacko, PT, DPT
• Savinder Singh Chadha, MD
• Christina S Chae, M.D.
• Granvia Chan
• Jan D Chang, MD
• Charles E Kaegi MD SC
• Jill Chasanov, R.N.
• Nicole Chase
• Gaurav Chaturvedi, MD
• Hamad M Chaudhary, M.D.

• General Practice Dentistry in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.