Luke Chang, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE61185255 Issued in WA

Practice address

Olympic Modern Dentistry, Point Fosdick Dr Ste 300
Gig Harbor, WA 98335-7491

Phone

(949) 394-7132

NPI assigned

Aug 31, 2021

Sex

Male

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

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

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1634515200000",
    "number": "1982372439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7312 57TH AVENUE CT NW",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983357491",
            "telephone_number": "949-394-7132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OLYMPIC MODERN DENTISTRY, POINT FOSDICK DR STE 300",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983357491",
            "telephone_number": "949-394-7132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "LUKE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-10-18",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DENT.DE.61185255",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61185255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chad Smart DDS and Vincent O Kokich Jr DMD MSD PLLC
• Chad Smart DDS and Vincent O Kokich Jr DMD MSD PLLC
• Chad Smart PLLC
• Helen J Chamberlin, LMP
• Michelle Chandler
• Margo Chang, LMP
• Cara Seidell Channing, OTR L MOT
• Leslie Charles, N.D.
• Luther Khanh Chau, DC, LMP
• Gagandeep Cheema, D.O.

• General Practice Dentistry in Gig Harbor, WA
• Providers in Gig Harbor, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2021; 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.