Provider Demographics
NPI:1154201895
Name:SHU MEI JESSIE CHANG DDS MS PLLC
Entity type:Organization
Organization Name:SHU MEI JESSIE CHANG DDS MS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNDER
Authorized Official - Prefix:
Authorized Official - First Name:SHU MEI JESSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHANG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:415-810-5318
Mailing Address - Street 1:1776 LANCASTER AVE STE 15
Mailing Address - Street 2:
Mailing Address - City:PAOLI
Mailing Address - State:PA
Mailing Address - Zip Code:19301-1550
Mailing Address - Country:US
Mailing Address - Phone:610-904-9005
Mailing Address - Fax:
Practice Address - Street 1:1776 LANCASTER AVE STE 15
Practice Address - Street 2:
Practice Address - City:PAOLI
Practice Address - State:PA
Practice Address - Zip Code:19301-1550
Practice Address - Country:US
Practice Address - Phone:610-904-9005
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-04
Last Update Date:2025-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty