Individual
JAE WHEE CHANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2244 JACKSON AVE APT 905, LONG ISLAND CITY, NY 11101-9411
(650) 833-9882
Mailing address
5203 CENTER BLVD APT 1225, LONG ISLAND CITY, NY 11101-6525
(650) 833-9882
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
064326-01
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/16/2023
Last updated
06/06/2025
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