Provider Demographics
NPI:1114170040
Name:CHANG, LI HUA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LI
Middle Name:HUA
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 1:4616 159TH ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11358-3629
Mailing Address - Country:US
Mailing Address - Phone:212-300-7275
Mailing Address - Fax:
Practice Address - Street 1:13338 41ST RD
Practice Address - Street 2:#1G
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3697
Practice Address - Country:US
Practice Address - Phone:718-321-8886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-22
Last Update Date:2008-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY04968211223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics