Healthcare Provider Details

I. General information

NPI: 1578893749
Provider Name (Legal Business Name): WEI-LING WU CHANG D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/11/2010
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 MAX DR STE 202
CASTLE PINES CO
80108-9519
US

IV. Provider business mailing address

250 MAX DR STE 202
CASTLE PINES CO
80108-9519
US

V. Phone/Fax

Practice location:
  • Phone: 720-733-7799
  • Fax: 720-733-0677
Mailing address:
  • Phone: 720-733-7799
  • Fax: 303-733-0677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number8008
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: