Provider Demographics
NPI:1093996845
Name:CHANG, JOSEPH HE (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:HE
Last Name:CHANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15090 W HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-6360
Mailing Address - Country:US
Mailing Address - Phone:623-535-9425
Mailing Address - Fax:
Practice Address - Street 1:14122 W MCDOWELL RD STE 200
Practice Address - Street 2:
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2505
Practice Address - Country:US
Practice Address - Phone:623-536-2040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-21
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD7281122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist