Provider Demographics
NPI:1447577283
Name:CHANG, KAI-HUI CARL (DDS)
Entity Type:Individual
Prefix:
First Name:KAI-HUI
Middle Name:CARL
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 1:13625 MAPLE AVE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11355-3870
Mailing Address - Country:US
Mailing Address - Phone:718-461-4731
Mailing Address - Fax:718-461-4803
Practice Address - Street 1:13625 MAPLE AVE
Practice Address - Street 2:SUITE 208
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11355-3870
Practice Address - Country:US
Practice Address - Phone:718-461-4731
Practice Address - Fax:718-461-4803
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-03
Last Update Date:2011-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY055583-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice