Provider Demographics
NPI:1659406007
Name:CHANG, YING-YI (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:YING-YI
Middle Name:
Last Name:CHANG
Suffix:
Gender:F
Credentials:DDS, MS
Other - Prefix:DR
Other - First Name:CHRISTINE
Other - Middle Name:
Other - Last Name:CHANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS, MS
Mailing Address - Street 1:288 S SAN GABRIEL BLVD
Mailing Address - Street 2:#205
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-1667
Mailing Address - Country:US
Mailing Address - Phone:626-285-6968
Mailing Address - Fax:626-285-0618
Practice Address - Street 1:288 S SAN GABRIEL BLVD STE 205
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-1668
Practice Address - Country:US
Practice Address - Phone:626-285-6968
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA458351223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics