Samuel Chong, DDS
Individual provider Active NPI General Practice Dentistry · Mercer Island, WA
NPI 1225611577 · NPPES record last updated Sep 2, 2023
Key facts
- NPI
- 1225611577
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- DE61178186 (WA)
- Practice address
- 3486 77TH Ave SE
Mercer Island, WA 98040-3444 - Phone
- (206) 370-9352
- NPI assigned
- May 4, 2021
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE61178186 | WA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sam Chong, DDS, P.L.L.C. | General Practice | Current |
Accepting new patients |
Locations
16306 Bothell Everett Hwy
Ste B
Mill Creek, WA 98012
Phone (425) 745-4661
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DE61178186 | WA | Yes |
Addresses
Primary practice location
3486 77TH Ave SE
Mercer Island, WA 98040-3444
Mailing address
3486 77TH Ave SE
Mercer Island, WA 98040-3444
Phone (206) 370-9352
Other providers in Mercer Island, WA
- Kiny Chea
- Jason CHI
- Children'S Institute for Learning Differences
- Jamie Samra Cho
- Nakyung Choe
- City of Mercer Island
- City of Mercer Island
- Erica Lynne Clark
- Tumaini Rucker Coker
- Paul Dewitt Conrad
All providers in Mercer Island, WA · General Practice Dentistry in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.