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Deactivated NPI 1356920060 Deactivated / Inactive NPI Male Practitioner

Dr. Dillon Chang , DMD

Dentist • Kent, WA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Dillon Chang has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date April 08, 2021
NPI Deactivation Date April 22, 2022
Total Practice Duration ~1 Years of Practice (2021 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Dillon Chang, DMD was a registered Dentist practicing in Kent, WA. Throughout an active medical career spanning 1 years, Dr. Chang provided care at the practice location at 10725 SE 256TH ST STE 1 until profile deactivation on 2022-04-22.

Practice Location & Contact Primary Location

Practice Address

10725 Se 256th St Ste 1

Kent, WA 980308285

Telephone 2538542714
Associated Practice Facility / Clinic
🏢 Dhaliwal, Dds, Pllc Facility NPI 1750834883

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Kent, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 19.0 Yrs
State Avg: 16.1 Yrs
Regional Practice Density
47 Specialists

Practicing in Kent, WA (2853 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-07-02
Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License WA DE61303625

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Student in an Organized Health Care Education/Training Program

NUCC Taxonomy Code: 390200000X

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
NPI 1124490537

Doctor of Dental Surgery

Dr. Donovan Yan , DMD

Dentist - General Practice

NPI 1134963077

Doctor of Dental Medicine

Karanjot Kaur

Dentist - General Practice

NPI 1891612495
NPI 1891825303

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

11 Historical Events
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Updated Practice Location July 02, 2022

Registered at 10725 SE 256TH ST STE 1, KENT, WA 980308285 (Tel: 2538542714)

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Updated Business Mailing Address July 02, 2022

Registered at 1232 RIDGE AVE UNIT 301, PHILADELPHIA, PA 191233390

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Provider Name / Credentials Updated July 02, 2022

Recorded as DILLON CHANG, DMD

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 02, 2022

Student in an Organized Health Care Education/Training Program

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NPI Profile Deactivated April 22, 2022

Record deactivated on April 22, 2022

NPI Profile Active April 08, 2021

NPI status registered as active in NPPES database

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Updated Practice Location April 08, 2021

Registered at 3223 N BROAD ST, PHILADELPHIA, PA 191405007 (Tel: 2157072900)

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Updated Business Mailing Address April 08, 2021

Registered at 1232 RIDGE AVE UNIT 301, PHILADELPHIA, PA 191233390

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Provider Name / Credentials Updated April 08, 2021

Recorded as DILLON CHANG

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Medical Taxonomy / Specialty Registered (Primary Specialty) April 08, 2021

Student in an Organized Health Care Education/Training Program

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Initial NPI Registration & Enumeration April 08, 2021

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1356920060
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 08, 2021
Last Update: July 02, 2022
Deactivation Date: April 22, 2022
Sole Proprietor: No

Mailing Address

1232 Ridge Ave Unit 301

Philadelphia, PA 191233390

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.