| Yoonho Chang Dds Inc. | |
|
7024 Airway Ave Suite A Yucca Valley CA 92284-3069 | |
| (760) 365-2351 | |
| Not Available |
| Full Name | Yoonho Chang Dds Inc. |
|---|---|
| Speciality | Dentist |
| Location | 7024 Airway Ave, Yucca Valley, California |
| Authorized Official Name and Position | Yoonho Chang (PRESIDENT) |
| Authorized Official Contact | 7603652351 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yoonho Chang Dds Inc. 7024 Airway Ave Suite A Yucca Valley CA 92284-3069 Ph: (760) 365-2351 | Yoonho Chang Dds Inc. 7024 Airway Ave Suite A Yucca Valley CA 92284-3069 Ph: (760) 365-2351 |
| NPI Number | 1750588646 |
|---|---|
| Provider Enumeration Date | 07/02/2007 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 2264834225 |
|---|---|
| Medicare Enrollment ID | O20210713002678 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750588646 | NPI | - | NPPES |
| G93623-01 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 48241 (California) | Primary |
| Provider Name | Yoonho Chang |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1770672719 PECOS PAC ID: 3173925138 Enrollment ID: I20210713002807 |
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