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NPI Code Detail

MEDICARE: YOUNGJUNE CHANG DDS LLC

MEDICARE: YOUNGJUNE CHANG DDS LLC
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
1122300000XDentist7139KS

General Provider Information

NPI Number : 1770688095
Entity Type Code : Organization
Provider Name (Legal Business Name) : YOUNGJUNE CHANG DDS LLC
Provider Business Mailing Address
First Line : 6708 STATE AVENUE
Second Line :
City : KANSAS CITY
State : KS
Zip : 66102
Country : US
Telephone Number : 913-299-8554
Fax Number : 913-299-3187
Provider Business Practice Location Address
First Line : 6708 STATE AVENUE
Second Line :
City : KANSAS CITY
State : KS
Zip : 66102
Country : US
Telephone Number : 913-299-8554
Fax Number : 913-299-3187
Authorized Official
Title or Position : OWNER DENTIST PRESIDENT
Name : DR. YOUNGJUNE CHANG
Credential : DDS
Telephone Number : 913-299-8554
Provider Enumeration Date : 09/13/2006
Last Update Date : 08/22/2020

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Directions to “YOUNGJUNE CHANG DDS LLC ” Practice Location

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