Healthcare Provider Details

I. General information

NPI: 1891600177
Provider Name (Legal Business Name): JUSTIN M. CHANG, DDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

850 W HIND DR STE 206
HONOLULU HI
96821-1845
US

IV. Provider business mailing address

610 LUNALILO HOME RD
HONOLULU HI
96825-2401
US

V. Phone/Fax

Practice location:
  • Phone: 808-377-5266
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JUSTIN MICHAEL CHANG
Title or Position: MANAGER
Credential: DDS
Phone: 713-412-9708