Provider Demographics
NPI:1558649210
Name:CHANG, YOON (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:YOON
Middle Name:
Last Name:CHANG
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2680 OLD DENTON RD # 108
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-5102
Mailing Address - Country:US
Mailing Address - Phone:972-242-2040
Mailing Address - Fax:972-242-7131
Practice Address - Street 1:2680 OLD DENTON RD # 108
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-5102
Practice Address - Country:US
Practice Address - Phone:972-242-2040
Practice Address - Fax:972-242-7131
Is Sole Proprietor?:No
Enumeration Date:2011-07-29
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX00271281223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics