Active NPI
Supak Choti, DDS
- Dentist
- Burney, CA
National Provider Identifier
1003003781
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 56408
- Practice address
- 38096 Highway 299 E
Burney, CA 96013-9792 - Phone
- (530) 410-5851
- NPI assigned
- Sep 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 56408 | CA | Primary |
Addresses
Primary practice location
38096 Highway 299 E
Burney, CA 96013-9792
Mailing address
3671 Foothill Blvd
Redding, CA 96001-0616
Phone (530) 510-3077
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 56408 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190764800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354579200000",
"number": "1003003781",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3671 FOOTHILL BLVD",
"city": "REDDING",
"state": "CA",
"postal_code": "960010616",
"telephone_number": "530-510-3077"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "38096 HIGHWAY 299 E",
"city": "BURNEY",
"state": "CA",
"postal_code": "960139792",
"telephone_number": "530-410-5851"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHOTI",
"first_name": "SUPAK",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-26",
"last_updated": "2012-12-04",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "56408",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "56408",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Burney, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.