Provider Demographics
NPI:1073145108
Name:JIEUN CHOI, DMD, PLLC
Entity Type:Organization
Organization Name:JIEUN CHOI, DMD, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADVISOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:Y
Authorized Official - Last Name:HWANG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-780-9437
Mailing Address - Street 1:11066 5TH AVE NE STE 105
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-6156
Mailing Address - Country:US
Mailing Address - Phone:206-362-6331
Mailing Address - Fax:
Practice Address - Street 1:11066 5TH AVE NE STE 105
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-6156
Practice Address - Country:US
Practice Address - Phone:206-362-6331
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-06
Last Update Date:2020-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental