NPIMap

Organization Active NPI

M. Cho, DDS, PLLC

Doing business as Crystal Dental Inc

  • Dental Clinic/Center
  • Renton, WA
National Provider Identifier
1689166084
Registry record updated May 31, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
DE60603860 Issued in WA
Legal business name
M. CHO, DDS, PLLC
Doing business as
Crystal Dental Inc
Practice address
12644 164TH Ave SE
Renton, WA 98059-6403
Phone
(425) 282-4182
NPI assigned
May 31, 2018
Last updated
May 31, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 31, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Michael Sungyun Cho, DDSNPI 1770954760
Title
Sole Member
Phone
(909) 362-6319

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X DE60603860 WA Primary

Addresses

Primary practice location

12644 164TH Ave SE
Renton, WA 98059-6403

Mailing address

2740 118TH Ave SE Apt 102
Bellevue, WA 98005-8130
Phone (909) 362-6319

Other names 1

  • CRYSTAL DENTAL INC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1527724800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1527724800000",
    "number": "1689166084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2740 118TH AVE SE APT 102",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980058130",
            "telephone_number": "909-362-6319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12644 164TH AVE SE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980596403",
            "telephone_number": "425-282-4182"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M. CHO, DDS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-31",
        "last_updated": "2018-05-31",
        "status": "A",
        "authorized_official_last_name": "CHO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "SUNGYUN",
        "authorized_official_title_or_position": "SOLE MEMBER",
        "authorized_official_telephone_number": "909-362-6319",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "DE60603860",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CRYSTAL DENTAL INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.