Provider Demographics
NPI:1013793793
Name:ANDING FAMILY DENTAL, PC
Entity type:Organization
Organization Name:ANDING FAMILY DENTAL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:CHANG-ANDING
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-616-4278
Mailing Address - Street 1:2430 S 73RD ST STE 202
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68124-2397
Mailing Address - Country:US
Mailing Address - Phone:402-933-4632
Mailing Address - Fax:
Practice Address - Street 1:2430 S 73RD ST STE 202
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68124-2397
Practice Address - Country:US
Practice Address - Phone:402-933-4632
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-07
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental