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General NPI Number Information
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NPI Number | 1114346301
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Entity Type | Individual
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Provider Name | MICHAEL WILLIAM CHANG D.D.S.
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Gender | Male
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Dates
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Enumeration Date | 04/15/2014
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Last Update Date | 07/23/2019
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Provider Practice Location Address
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Address Line | 12450 EAST FWY STE 140
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City | HOUSTON
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State | TX
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Zip | 77015
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Country | US
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Telephone | 832-872-2930
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 GEMINI ST APT 1209
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City | HOUSTON
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State | TX
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Zip | 77058-6015
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Country | US
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Telephone | 770-883-6187
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 33543
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN014748
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 33543
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License Number State | TX
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