Provider Demographics
NPI:1649492570
Name:CHIN, NIKKI HIROYE (DDS)
Entity type:Individual
Prefix:DR
First Name:NIKKI
Middle Name:HIROYE
Last Name:CHIN
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 1:15808 MILL CREEK BLVD
Mailing Address - Street 2:SUITE 130
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1500
Mailing Address - Country:US
Mailing Address - Phone:425-379-8038
Mailing Address - Fax:425-316-0395
Practice Address - Street 1:15808 MILL CREEK BLVD
Practice Address - Street 2:SUITE 130
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1500
Practice Address - Country:US
Practice Address - Phone:425-379-8038
Practice Address - Fax:425-316-0395
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-02
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE00010647122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist