Provider Demographics
NPI:1184280943
Name:WESTERVILLE DENTAL ASSOCIATES LLC - SUE Y CHOI DDS & YUCHAN K SON DDS
Entity type:Organization
Organization Name:WESTERVILLE DENTAL ASSOCIATES LLC - SUE Y CHOI DDS & YUCHAN K SON DDS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SUE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:614-882-1135
Mailing Address - Street 1:627 OFFICE PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:WESTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43082-7812
Mailing Address - Country:US
Mailing Address - Phone:614-882-1135
Mailing Address - Fax:
Practice Address - Street 1:627 OFFICE PKWY STE A
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-7812
Practice Address - Country:US
Practice Address - Phone:614-882-1135
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-16
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies