Healthcare Provider Details

I. General information

NPI: 1285982918
Provider Name (Legal Business Name): DANIEL H CHONG DDS PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2012
Last Update Date: 06/06/2024
Certification Date: 06/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33301 9TH AVE SO. SUITE 125
FEDERAL WAY WA
98003
US

IV. Provider business mailing address

33301 9TH AVE SO. SUITE 125
FEDERAL WAY WA
98003
US

V. Phone/Fax

Practice location:
  • Phone: 253-946-6361
  • Fax: 253-838-1750
Mailing address:
  • Phone: 253-946-6361
  • Fax: 253-838-1750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BC3200X
TaxonomyCustomized Equipment (DME)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State

VIII. Authorized Official

Name: DR. DANIEL H CHONG
Title or Position: OWNER
Credential: D.D.S.
Phone: 253-946-6361