Kearny Chang

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

205687 Issued in CO

Practice address

8000 E Prentice Ave
Greenwood Village, CO 80111-2744

Phone

(720) 370-2130

NPI assigned

Feb 25, 2019

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

Enrolled in CO

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1551052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1982161006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8000 E PRENTICE AVE",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112744",
            "telephone_number": "720-370-2130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8000 E PRENTICE AVE",
            "city": "GREENWOOD VILLAGE",
            "state": "CO",
            "postal_code": "801112744",
            "telephone_number": "720-370-2130"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3920 N Union Blvd Ste 380",
            "address_purpose": "LOCATION",
            "city": "Colorado Springs",
            "state": "CO",
            "postal_code": "809074922",
            "country_code": "US",
            "telephone_number": "719-892-1918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHANG",
        "first_name": "KEARNY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-02-25",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CO",
            "license": "205687",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "36075",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Garrett Chaffee
• Alicia Chaffin
• Selonda Chambers, AU.D.
• Traci Chambers, MED,OTR/L
• Bradford Champlin, LMT
• Yen-Chen Chang, OTR, PH.D.
• Change Academy at Lake of the Ozarks
• Change Academy at Lake of the Ozarks
• Weng Ian Chao, PHD
• Sarah Lynn Charboneau, COTA/L

• Periodontics in Greenwood Village, CO
• Providers in Greenwood Village, CO by specialty
• Periodontics in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.