Provider Demographics
NPI:1003255217
Name:CHANG, LINDSEY STEPHANIE (DMD, INC)
Entity Type:Individual
Prefix:DR
First Name:LINDSEY
Middle Name:STEPHANIE
Last Name:CHANG
Suffix:
Gender:F
Credentials:DMD, INC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2521 WORTHINGTON ST APT 307
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2585
Mailing Address - Country:US
Mailing Address - Phone:954-809-1255
Mailing Address - Fax:
Practice Address - Street 1:2465 IRON POINT RD STE 120
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-8754
Practice Address - Country:US
Practice Address - Phone:916-984-9600
Practice Address - Fax:916-984-9076
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2019-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN20167122300000X, 1223E0200X
CADDS1045371223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No122300000XDental ProvidersDentist