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General NPI Number Information
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NPI Number | 1831256072
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Entity Type | Individual
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Provider Name | HEERA CHANG M.D., DDS
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Gender | Female
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 06/17/2025
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Provider Practice Location Address
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Address Line | 263 FARMINGTON AVE
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City | FARMINGTON
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State | CT
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Zip | 06030-0001
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Country | US
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Telephone | 860-679-2207
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Fax | 860-679-1363
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Provider Business Mailing Address
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Address Line | 263 FARMINGTON AVE
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City | FARMINGTON
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State | CT
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Zip | 06030-0001
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Country | US
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Telephone | 860-679-2207
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Fax | 860-679-1363
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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 | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 14394
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | CSDT-80
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DN1855289
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | 17632
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License Number State | HI
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