PHILIP CHANG DDS DENTAL CORPORATION (NPI# 1245870765) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245870765 |
| Entity Type | Organization |
| Organization Name | PHILIP CHANG DDS DENTAL CORPORATION |
| Other Organization Name | CREATE SMILES DENTAL |
| Practice Address |
1611 Crenshaw Blvd Ste C Torrance CA 90501-7124 |
| Practice Telephone | 3107917108 |
| Practice Fax Number | 3107917142 |
| Mailing Telephone | 4247317096 |
| Mailing Fax Number | 4247317042 |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2020-09-23 |
| Authorized Official Name | DR. PHILIP MINSUK CHANG (CEO) |
| Authorized Official Telephone | 4247317096 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | GENERAL | 51048 | 01 |
| Other Name | Type Code |
|---|---|
| Create Smiles Dental | Doing Business As Name - Organization |
| Street Address |
1611 CRENSHAW BLVD STE C |
| City | TORRANCE |
| State | CA |
| Zip Code | 90501-7124 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588771505 | Philip Minsuk Chang | Dentist | 1611 Crenshaw Blvd Ste C, Torrance, CA 90501-7124 | 2006-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700351145 | Brittany Ford | Behavior Technician | 701 Van Ness Way, Ste. 710, Sacrmamento, CA 90501 | 2018-10-12 |
| 1912417999 | Wellspring of Life Counseling Center, Inc. | Counselor | 2008 West Carson Street, Suite 105, Torrance, CA 90501 | 2017-10-04 |
| 1902325517 | Diane Elizabeth Rogers | Counselor | 20300 S. Vermont Ave, Suite 275, Torrance, CA 90501 | 2017-09-14 |
| 1124545397 | Daniel Benjamin | Social Worker | 1617 Cravens Ave., Torrance, CA 90501 | 2017-08-28 |
| 1194246819 | Rebecca Senter | Counselor | 1124 W. Carson St N33, Torrance, CA 90501 | 2017-07-03 |
| 1932638376 | Anderson Development Licensed Clinical Social Worker Inc | Social Worker | 21151 S Western Ave Ste 174, Torrance, CA 90501 | 2017-06-08 |
| 1548796626 | Green Meadow Homes, Inc. | Skilled Nursing Facility | 2460 W. 229th Street, Torrance, CA 90501 | 2017-05-10 |
| 1134679558 | Stacey Rose Garcia | Student in an Organized Health Care Education/Training Program | 1445 W 214th St, Torrance, CA 90501 | 2016-10-10 |
| 1700333002 | Veronica Mayela Martinez | Marriage & Family Therapist | 1523 W. 228th St Apt. A, Torrance, CA 90501 | 2016-09-02 |
| 1124453030 | Garfield Beach Cvs LLC | Durable Medical Equipment & Medical Supplies | 1303 W Sepulveda Blvd, Torrance, CA 90501 | 2013-09-10 |
| Find all providers in zip 90501 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932690831 | Daryn T. Nishikawa, D.d.s., Inc | Clinic/Center | 3556 Torrance Blvd Ste C, Torrance, CA 90503-4891 | 2018-05-25 |
| 1881064277 | Bardi-nugent Dental Corporation | Clinic/Center | 3663 Torrance Blvd Ste 3, Torrance, CA 90503-4817 | 2015-09-29 |
| 1205241494 | Henry S. Lee, D.d.s. Incorporated | Clinic/Center | 23000 Crenshaw Blvd Ste 102, Torrance, CA 90505-3059 | 2014-06-25 |
| 1447423264 | Jades Dentistry | Clinic/Center | 23440 Hawthorne Blvd Ste 110, Torrance, CA 90505-4768 | 2008-04-12 |
| 1053925248 | Dr. Sahar A. Mehr D.d.s Inc. | Clinic/Center | 23545 Crenshaw Blvd Ste 105, Torrance, CA 90505-5282 | 2020-09-04 |
| 1982064382 | Rootvision Endo | Clinic/Center | 3663 Torrance Blvd Ste 3, Torrance, CA 90503-4817 | 2016-02-26 |
| 1083081236 | Sho Izumi, Dds, Inc | Clinic/Center | 23545 Crenshaw Blvd, Suite 105, Torrance, CA 90505-5218 | 2015-08-24 |
| 1659757698 | Sachi A Fujita Dds A Professional Corporation | Clinic/Center | 23545 Crenshaw Blvd, Suite 105, Torrance, CA 90505-5218 | 2015-07-31 |
| 1689053530 | Steven K Okamoto | Clinic/Center | 22330 Hawthorne Blvd, Suite E, Torrance, CA 90505 | 2015-05-26 |
| 1558749531 | E.c. Lobo-marwah, Dds., Inc | Clinic/Center | 3640 Lomita Blvd, Ste 202, Torrance, CA 90505-3927 | 2015-05-11 |
| Find all providers in TORRANCE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.