NPIMap

Individual provider Active NPI

Kevin Hyung Choi, D.D.S.

  • General Practice Dentistry
  • Mesa, AZ
National Provider Identifier
1003963398
Registry record updated Nov 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8358 Issued in AZ
Practice address
4434 E. Brown Rd Ste 104
Mesa, AZ 85205
Phone
(480) 654-3000
Fax
(480) 654-0303
NPI assigned
Jan 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 30, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 49496 CA
General Practice Dentistry 1223G0001X 8358 AZ Primary

Addresses

Primary practice location

4434 E. Brown Rd Ste 104
Mesa, AZ 85205

Mailing address

4434 E. Brown Rd. Ste 104
Mesa, AZ 85205
Phone (714) 573-7100

Other identifiers 3

IdentifierTypeStateIssuer
1731906OtherCAUNITED CONCORDIA
906134OtherCADELTA DENTAL HEALTHY FAM
G93335-01MedicaidCA

Other names 1

  • Dr. Hung Seok Choi Former name

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
49496CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Fabulous Smiles of Mesa General Practice Past Accepting new patients
Heap and Bunker Dental Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354233600000",
    "number": "1003963398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4434 E. BROWN RD. STE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85205",
            "telephone_number": "714-573-7100",
            "fax_number": "714-505-0101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4434 E. BROWN RD STE 104",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "85205",
            "telephone_number": "480-654-3000",
            "fax_number": "480-654-0303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "KEVIN",
        "middle_name": "HYUNG",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-05",
        "last_updated": "2012-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49496",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "8358",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1731906",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL HEALTHY FAM",
            "identifier": "906134",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G93335-01",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HUNG",
            "last_name": "CHOI",
            "middle_name": "SEOK",
            "prefix": "DR.",
            "credential": "D.D.S.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.

Verify at the official NPI Registry.