Healthcare Provider Details

I. General information

NPI: 1134005168
Provider Name (Legal Business Name): ERINN CHANG DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 06/20/2026
Certification Date: 06/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1660 HILLSDALE AVE STE 100
SAN JOSE CA
95124-3243
US

IV. Provider business mailing address

215 QUEST PARK ST APT 234
HENDERSON NV
89074-1491
US

V. Phone/Fax

Practice location:
  • Phone: 408-267-1881
  • Fax:
Mailing address:
  • Phone: 408-516-7183
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number112799
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: