Provider Demographics
NPI:1417082652
Name:CHOI, KEVIN Y (DMD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:Y
Last Name:CHOI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 116TH AVE NE #102
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004
Mailing Address - Country:US
Mailing Address - Phone:425-454-4582
Mailing Address - Fax:
Practice Address - Street 1:1515 116TH AVE NE
Practice Address - Street 2:SUITE 301
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-3811
Practice Address - Country:US
Practice Address - Phone:425-454-4582
Practice Address - Fax:425-646-9430
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2015-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA79991223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics