Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 122300000X | Dentist | DN20167 | FL |
Y | 1223E0200X | Endodontist | DDS104537 | CA |
N | 1223E0200X | Endodontist | DN20167 | FL |
NPI | 1003255217 |
---|---|
Provider Name | Dr. Lindsey Stephanie Chang |
First Address | Dallas, TX 75204-2585 |
Second Address | Folsom, CA 95630-8754 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2013 |
Last Update Date | 22/11/2019 |