Healthcare Provider Details

I. General information

NPI: 1528455086
Provider Name (Legal Business Name): VAN H VUONG DDS & CINDY H CHOU DDS 3, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2015
Last Update Date: 04/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34704 11TH PL S # 101
FEDERAL WAY WA
98003-8730
US

IV. Provider business mailing address

34704 11TH PL S # 101
FEDERAL WAY WA
98003-8730
US

V. Phone/Fax

Practice location:
  • Phone: 253-946-5322
  • Fax: 253-946-1353
Mailing address:
  • Phone: 253-946-5322
  • Fax: 253-946-1353

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: CINDY HUANG CHOU
Title or Position: VP
Credential: DDS
Phone: 206-291-6514