Provider Demographics
NPI:1790127769
Name:CHOI, SENG KYU (DMD, MPH)
Entity Type:Individual
Prefix:DR
First Name:SENG KYU
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:DMD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14201 BRUCE B DOWNS BLVD STE 1
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33613-3906
Mailing Address - Country:US
Mailing Address - Phone:813-816-0798
Mailing Address - Fax:
Practice Address - Street 1:14201 BRUCE B DOWN SUITE #1. COMMUNITY SMILES P.A.
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33613-8255
Practice Address - Country:US
Practice Address - Phone:813-977-6962
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-19
Last Update Date:2019-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1131122300000X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No122300000XDental ProvidersDentist