MEDICARE: DENNIS WILLIAM CHANG

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program
2	1223G0001X	General Practice Dentistry	DN1857726	MA

General Provider Information

NPI Number	:	1396265203
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENNIS WILLIAM CHANG

Provider Business Mailing Address
First Line	:	915 N ST SE BLDG 175
Second Line	:
City	:	WASHINGTON NAVY YARD
State	:	DC
Zip	:	20374-5162
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	915 N ST SE BLDG 175
Second Line	:
City	:	WASHINGTON NAVY YARD
State	:	DC
Zip	:	20374-5162
Country	:	US
Telephone Number	:	202-433-0813
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/21/2017
Last Update Date	:	03/21/2025

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Directions to “ DENNIS WILLIAM CHANG ” Practice Location

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