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General NPI Number Information
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NPI Number | 1538656103
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Entity Type | Individual
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Provider Name | CHING-WEN TINA CHANG
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Gender | Female
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Dates
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Enumeration Date | 04/18/2018
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Last Update Date | 02/23/2021
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Provider Practice Location Address
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Address Line | 161 REGENT ST APT 19
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-3342
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Country | US
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Telephone | 347-720-1845
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Fax |
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Provider Business Mailing Address
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Address Line | 161 REGENT ST APT 19
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-3342
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Country | US
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Telephone | 347-720-1845
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 060780
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License Number State | NY
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