Provider Demographics
NPI:1326311911
Name:KUO, JOAN TSUZONG (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOAN
Middle Name:TSUZONG
Last Name:KUO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:989 112TH AVE NE
Mailing Address - Street 2:APT 905
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-4583
Mailing Address - Country:US
Mailing Address - Phone:425-247-5678
Mailing Address - Fax:
Practice Address - Street 1:116 SW 148TH ST
Practice Address - Street 2:SUITE D100
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-1983
Practice Address - Country:US
Practice Address - Phone:206-246-7999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-14
Last Update Date:2012-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE601609441223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice