Provider Demographics
NPI:1598977225
Name:CHANG, E. CHENG-HSIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:E. CHENG-HSIN
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 PETTICOAT LN
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94596-5017
Mailing Address - Country:US
Mailing Address - Phone:925-934-3395
Mailing Address - Fax:925-934-3397
Practice Address - Street 1:130 PETTICOAT LN
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-5017
Practice Address - Country:US
Practice Address - Phone:925-934-3395
Practice Address - Fax:925-934-3397
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2016-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA303351223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice