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General NPI Number Information
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NPI Number | 1922650589
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Entity Type | Individual
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Provider Name | JONATHAN CHOI DDS
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Gender | Male
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Dates
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Enumeration Date | 07/14/2019
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Last Update Date | 07/14/2019
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Provider Practice Location Address
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Address Line | 1715 MARKET ST STE 104
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City | KIRKLAND
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State | WA
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Zip | 98033-4968
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Country | US
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Telephone | 425-822-0435
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Fax |
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Provider Business Mailing Address
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Address Line | 27705 MAPLE RIDGE WAY SE
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City | MAPLE VALLEY
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State | WA
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Zip | 98038-2009
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Country | US
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Telephone | 425-761-0271
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DE60958069
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License Number State | WA
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