Healthcare Provider Details

I. General information

NPI: 1891699070
Provider Name (Legal Business Name): DILLON CHANG DMD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

827 BLOSSOM HILL RD STE W3
SAN JOSE CA
95123-2701
US

IV. Provider business mailing address

827 BLOSSOM HILL RD STE W3
SAN JOSE CA
95123-2701
US

V. Phone/Fax

Practice location:
  • Phone: 408-224-2000
  • Fax:
Mailing address:
  • Phone: 408-224-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number StateNULL

VIII. Authorized Official

Name: DILLON CHANG
Title or Position: PRESIDENT
Credential: DMD
Phone: 408-569-1890