Provider Demographics
NPI:1114009644
Name:CHANG, ROY HSIUNG (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:HSIUNG
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 1:7927 PAINTER AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602-2414
Mailing Address - Country:US
Mailing Address - Phone:562-945-1149
Mailing Address - Fax:562-945-6071
Practice Address - Street 1:7927 PAINTER AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602-2414
Practice Address - Country:US
Practice Address - Phone:562-945-1149
Practice Address - Fax:562-945-6071
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA343131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice