Provider Demographics
NPI:1265698021
Name:CHANG, YU-CHIEN (DDS)
Entity type:Individual
Prefix:
First Name:YU-CHIEN
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8616 QUEENS BLVD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-4433
Mailing Address - Country:US
Mailing Address - Phone:718-457-8787
Mailing Address - Fax:
Practice Address - Street 1:19216 50TH AVE
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-1204
Practice Address - Country:US
Practice Address - Phone:917-575-6657
Practice Address - Fax:718-457-2501
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-31
Last Update Date:2009-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02256600122300000X
NY050450122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist