Provider Demographics
NPI:1093843922
Name:CHUANG, CHUNYAO RYAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHUNYAO
Middle Name:RYAN
Last Name:CHUANG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:RYAN
Other - Middle Name:
Other - Last Name:CHUANG
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:3830 COLBY AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-4913
Mailing Address - Country:US
Mailing Address - Phone:425-259-0076
Mailing Address - Fax:425-259-0077
Practice Address - Street 1:3830 COLBY AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4913
Practice Address - Country:US
Practice Address - Phone:425-259-0076
Practice Address - Fax:425-259-0077
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE000084931223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5034897Medicaid