Provider Demographics
NPI:1306281241
Name:CHEUNG, BRIAN H (DDS)
Entity type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:H
Last Name:CHEUNG
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 1:509 OLIVE WAY STE 1331
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1743
Mailing Address - Country:US
Mailing Address - Phone:206-412-8554
Mailing Address - Fax:
Practice Address - Street 1:509 OLIVE WAY STE 1331
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1743
Practice Address - Country:US
Practice Address - Phone:206-624-0852
Practice Address - Fax:206-622-2084
Is Sole Proprietor?:No
Enumeration Date:2013-05-06
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY93641223G0001X, 1223S0112X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program