Provider Demographics
NPI:1609854926
Name:CHONG, DANIEL HYUN (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:HYUN
Last Name:CHONG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33301 9TH AVE S STE 125
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-2600
Mailing Address - Country:US
Mailing Address - Phone:253-946-6361
Mailing Address - Fax:253-838-1750
Practice Address - Street 1:33301 9TH AVE S STE 125
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-2600
Practice Address - Country:US
Practice Address - Phone:253-946-6361
Practice Address - Fax:253-838-1750
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT22061223P0700X
WADE00010313122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0700XDental ProvidersDentistProsthodontics