Federal Way Dental Clinic

Primary specialty

Preferred Provider OrganizationTaxonomy code 305R00000X

License

DE00009186 Issued in WA

Legal business name

FEDERAL WAY DENTAL CLINIC

Practice address

2016 S 320TH St
Suite F
Federal Way, WA 98003-5453

Phone

(253) 839-8106

Fax

(253) 941-7989

NPI assigned

Aug 9, 2016

Organization subpart

No

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

Authorized official

Name

Mr. Yong K Park, DDS

Title

Owner

Phone

(253) 839-8106

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Su-Young Jane Choi, DDS

  • Dentist
  • Federal Way, WA
  • NPI 1427692987
  NPD (past)

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

{
    "created_epoch": "1470700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470700800000",
    "number": "1760936637",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2016 S 320TH ST",
            "address_2": "SUITE F",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035453",
            "telephone_number": "253-839-8106",
            "fax_number": "253-941-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2016 S 320TH ST",
            "address_2": "SUITE F",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035453",
            "telephone_number": "253-839-8106",
            "fax_number": "253-941-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FEDERAL WAY DENTAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-09",
        "last_updated": "2016-08-09",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "YONG",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "253-839-8106",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "305R00000X",
            "taxonomy_group": "",
            "desc": "Preferred Provider Organization",
            "state": "WA",
            "license": "DE00009186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Federal Way Accident and Injury Clinic PS
• Federal Way Acupuncture Center, PLLC
• Federal Way Audiology, LLC
• Federal Way Birth Center
• Federal Way Chiropractic PS
• Federal Way Dental LLC
• Federal Way Family Physicians
• Federal Way Medical Equipment Inc
• Federal Way Medical Investors, LLC
• Federal Way Muscular Therapy

• Preferred Provider Organization in Federal Way, WA
• Providers in Federal Way, WA by specialty
• Preferred Provider Organization in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2016; 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.