Individual provider Active NPI

Charles Jae Choi, DDS

  • General Practice Dentistry
  • Cedar Rapids, IA
National Provider Identifier
1003824517
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6642 Issued in IA
Practice address
3500 Center Point Rd NE
Suite3
Cedar Rapids, IA 52402-5566
Phone
(319) 393-4828
Fax
(319) 393-5816
NPI assigned
Aug 3, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6642 IA Primary

Addresses

Primary practice location

3500 Center Point Rd NE
Suite3
Cedar Rapids, IA 52402-5566

Mailing address

3500 Center Point Rd NE Ste 3
Cedar Rapids, IA 52402-5566
Phone (319) 393-4828

Other identifiers 1

IdentifierTypeStateIssuer
0035022MedicaidIA

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

State licenses

LicenseStateTypeSpecialty
6642IAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003824517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3500 CENTER POINT RD NE STE 3",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025566",
            "telephone_number": "319-393-4828",
            "fax_number": "319-393-5816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3500 CENTER POINT RD NE",
            "address_2": "SUITE3",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524025566",
            "telephone_number": "319-393-4828",
            "fax_number": "319-393-5816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "CHARLES",
        "middle_name": "JAE",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "6642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0035022",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.