Provider Demographics
NPI:1225491517
Name:CHOE, JI-EUN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JI-EUN
Middle Name:
Last Name:CHOE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:JI-EUN
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12644 164TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98059-6403
Mailing Address - Country:US
Mailing Address - Phone:425-282-4182
Mailing Address - Fax:425-572-6072
Practice Address - Street 1:12644 164TH AVE SE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98059
Practice Address - Country:US
Practice Address - Phone:425-282-4182
Practice Address - Fax:425-572-6072
Is Sole Proprietor?:No
Enumeration Date:2016-04-04
Last Update Date:2018-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60660409122300000X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist