Provider Demographics
NPI:1669725610
Name:CHOI, YONGCHANG (DDS, MS, PHD)
Entity type:Individual
Prefix:DR
First Name:YONGCHANG
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:DDS, MS, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16705 SE 63RD PL
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-5640
Mailing Address - Country:US
Mailing Address - Phone:909-583-1881
Mailing Address - Fax:
Practice Address - Street 1:33838 PACIFIC HWY S STE B101
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6887
Practice Address - Country:US
Practice Address - Phone:253-838-4363
Practice Address - Fax:253-838-8805
Is Sole Proprietor?:No
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE601268151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice