Provider Demographics
NPI:1790409316
Name:CHOI, DAIHYUN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAIHYUN
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 D ST APT 219
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-1984
Mailing Address - Country:US
Mailing Address - Phone:907-917-8686
Mailing Address - Fax:
Practice Address - Street 1:1921 W DIMOND BLVD STE 101
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99515-1465
Practice Address - Country:US
Practice Address - Phone:908-386-4478
Practice Address - Fax:907-330-3390
Is Sole Proprietor?:No
Enumeration Date:2022-09-27
Last Update Date:2022-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK196950122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist