Provider Demographics
NPI:1013323518
Name:CHOI, MINYOUNG (DDS)
Entity Type:Individual
Prefix:
First Name:MINYOUNG
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 1:3218 NE 12TH ST
Mailing Address - Street 2:STE B
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98056-3405
Mailing Address - Country:US
Mailing Address - Phone:425-430-2029
Mailing Address - Fax:425-430-2029
Practice Address - Street 1:1450 WASHINGTON BLVD
Practice Address - Street 2:710S
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06902-2451
Practice Address - Country:US
Practice Address - Phone:425-772-8986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-03
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT011205122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist