Provider Demographics
NPI:1750472858
Name:CHANG, ROBERT NGHIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:NGHIA
Last Name:CHANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3315 BURKE RD STE 303
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:TX
Mailing Address - Zip Code:77504-1825
Mailing Address - Country:US
Mailing Address - Phone:713-947-0293
Mailing Address - Fax:713-947-0600
Practice Address - Street 1:3315 BURKE RD STE 303
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:TX
Practice Address - Zip Code:77504-1825
Practice Address - Country:US
Practice Address - Phone:713-947-0293
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-27
Last Update Date:2022-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX209801223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1089-01OtherBLUE CROSS/BLUE SHIELD
TX1399766OtherUN. CON
TX1399766OtherUN. CON