Provider Demographics
NPI:1477865061
Name:CHANG, PEARLINE YING-FONG (DDS, MS)
Entity Type:Individual
Prefix:
First Name:PEARLINE
Middle Name:YING-FONG
Last Name:CHANG
Suffix:
Gender:F
Credentials:DDS, MS
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Other - First Name:
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Mailing Address - Street 1:3980 SAN PABLO DAM ROAD
Mailing Address - Street 2:STE 100
Mailing Address - City:EL SOBRANTE
Mailing Address - State:CA
Mailing Address - Zip Code:94803-2840
Mailing Address - Country:US
Mailing Address - Phone:510-222-1441
Mailing Address - Fax:510-223-2317
Practice Address - Street 1:3980 SAN PABLO DAM ROAD
Practice Address - Street 2:STE 100
Practice Address - City:EL SOBRANTE
Practice Address - State:CA
Practice Address - Zip Code:94803-2840
Practice Address - Country:US
Practice Address - Phone:510-222-1441
Practice Address - Fax:510-223-2317
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA539791223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry