Provider Demographics
NPI:1942653910
Name:HWANG, DANIEL (DMD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:HWANG
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 1:14170 NE 183RD ST UNIT 312
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-7076
Mailing Address - Country:US
Mailing Address - Phone:206-579-2792
Mailing Address - Fax:
Practice Address - Street 1:24003 BOTHELL EVERETT HWY # 100
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98021-9342
Practice Address - Country:US
Practice Address - Phone:425-486-4428
Practice Address - Fax:425-487-0030
Is Sole Proprietor?:No
Enumeration Date:2016-07-14
Last Update Date:2017-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60729401122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist