Healthcare Provider Details

I. General information

NPI: 1952254799
Provider Name (Legal Business Name): JAYLEN NCHANG LEAD RISK ASSESSOR
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: NCHANG NCHANG LEAD RISK ASSESSOR

II. Dates (important events)

Enumeration Date: 02/20/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6340 BELL STATION RD
GLENN DALE MD
20769-9143
US

IV. Provider business mailing address

6340 BELL STATION RD
GLENN DALE MD
20769-9143
US

V. Phone/Fax

Practice location:
  • Phone: 571-330-4365
  • Fax:
Mailing address:
  • Phone: 571-330-4365
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number100802
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberDC24-4188
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number100802
License Number StateMD
# 4
Primary TaxonomyN
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberDC24-4188
License Number StateDC
# 5
Primary TaxonomyN
Taxonomy Code247200000X
TaxonomyOther Technician
License NumberDC24-4188
License Number StateDC
# 6
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number100802
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: