Healthcare Provider Details

I. General information

NPI: 1528429859
Provider Name (Legal Business Name): ANDREW HONG DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/14/2016
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25022 104TH AVE SE STE B
KENT WA
98030-2822
US

IV. Provider business mailing address

25022 104TH AVE SE STE B
KENT WA
98030-2822
US

V. Phone/Fax

Practice location:
  • Phone: 253-600-0000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number70007743
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: