Provider Demographics
NPI:1407166267
Name:CHANG CHAY, CINDY (DMD)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:CHANG CHAY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 SMITH ST STE 103
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-2963
Mailing Address - Country:US
Mailing Address - Phone:845-624-0011
Mailing Address - Fax:
Practice Address - Street 1:25 SMITH ST STE 103
Practice Address - Street 2:
Practice Address - City:NANUET
Practice Address - State:NY
Practice Address - Zip Code:10954-2963
Practice Address - Country:US
Practice Address - Phone:845-624-0011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-14
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D102448600122300000X
NY50055676122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist