Provider Demographics
NPI:1598318255
Name:CHOI, YON
Entity Type:Individual
Prefix:
First Name:YON
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16400 SOUTHCENTER PKWY STE 103
Mailing Address - Street 2:
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98188-3330
Mailing Address - Country:US
Mailing Address - Phone:206-575-0400
Mailing Address - Fax:
Practice Address - Street 1:16400 SOUTHCENTER PKWY STE 103
Practice Address - Street 2:
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98188-3330
Practice Address - Country:US
Practice Address - Phone:206-575-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-22
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1041151223G0001X
WADE613116341223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice