Provider Demographics
NPI:1841559887
Name:CHOI, SOOKYOUNG (DDS)
Entity Type:Individual
Prefix:
First Name:SOOKYOUNG
Middle Name:
Last Name:CHOI
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 1:113 CRYSTAL SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:EAST AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14051-1477
Mailing Address - Country:US
Mailing Address - Phone:716-631-2728
Mailing Address - Fax:716-631-5821
Practice Address - Street 1:4927 MAIN ST
Practice Address - Street 2:ROBERT J LAQCARRUBBA DDS PC
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-4081
Practice Address - Country:US
Practice Address - Phone:716-631-2728
Practice Address - Fax:716-631-5821
Is Sole Proprietor?:No
Enumeration Date:2012-05-11
Last Update Date:2016-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0569571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice