Provider Demographics
NPI:1669523775
Name:CHANG, CHRISTINA YA-NI (DDS)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:YA-NI
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 1:500 SPRUCE ST RM 100
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118
Mailing Address - Country:US
Mailing Address - Phone:415-751-5405
Mailing Address - Fax:415-751-5408
Practice Address - Street 1:500 SPRUCE ST RM 100
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118
Practice Address - Country:US
Practice Address - Phone:415-751-5405
Practice Address - Fax:415-751-5408
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-15
Last Update Date:2010-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA537691223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice