Provider Demographics
NPI:1518105659
Name:CHER Y. CHANG, DMD, P.C.
Entity Type:Organization
Organization Name:CHER Y. CHANG, DMD, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHER
Authorized Official - Middle Name:Y
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:702-416-9955
Mailing Address - Street 1:550 S DECATUR BLVD
Mailing Address - Street 2:CHARLESTON HEIGHTS SHOPPING CENTER
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89107-3911
Mailing Address - Country:US
Mailing Address - Phone:702-416-9955
Mailing Address - Fax:702-416-9957
Practice Address - Street 1:550 S DECATUR BLVD
Practice Address - Street 2:CHARLESTON HEIGHTS SHOPPING CENTER
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89107-3911
Practice Address - Country:US
Practice Address - Phone:702-416-9955
Practice Address - Fax:702-416-9957
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-28
Last Update Date:2009-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV4862122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty