Provider Demographics
NPI:1578343240
Name:CAPE COD DENTAL GROUP
Entity Type:Organization
Organization Name:CAPE COD DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHING-JU
Authorized Official - Middle Name:JENNY
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:508-654-8588
Mailing Address - Street 1:129 ROUTE 28
Mailing Address - Street 2:
Mailing Address - City:WEST HARWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02671-1221
Mailing Address - Country:US
Mailing Address - Phone:508-214-4249
Mailing Address - Fax:
Practice Address - Street 1:129 ROUTE 28
Practice Address - Street 2:
Practice Address - City:WEST HARWICH
Practice Address - State:MA
Practice Address - Zip Code:02671-1221
Practice Address - Country:US
Practice Address - Phone:508-214-4249
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-02
Last Update Date:2023-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty