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General NPI Number Information
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NPI Number | 1972256535
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Entity Type | Organization
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Legal Business Name | YOUNG J. CHANG DDS INC.
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Dates
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Enumeration Date | 02/02/2022
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Last Update Date | 02/02/2022
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Provider Practice Location Address
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Address Line | 1174 CASTRO ST STE 114
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City | MOUNTAIN VIEW
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State | CA
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Zip | 94040-2572
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Country | US
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Telephone | 650-965-1595
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Fax |
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Provider Business Mailing Address
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Address Line | 19714 VINEYARD LN
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City | SARATOGA
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State | CA
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Zip | 95070-4562
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | YOUNG JUN CHANG
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Credential | DDS
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Telephone | 408-569-8402
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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