Individual provider Active NPI

Jieun Choi, D.M.D.

  • Dentist
  • Seattle, WA
National Provider Identifier
1053630632
Registry record updated May 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60751947 Issued in WA
Practice address
11066 5TH Ave NE Ste 105
Seattle, WA 98125-6156
Phone
(206) 362-6331
NPI assigned
May 22, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60751947 WA Primary

Addresses

Primary practice location

11066 5TH Ave NE Ste 105
Seattle, WA 98125-6156

Mailing address

11066 5TH Ave NE Ste 105
Seattle, WA 98125-6156
Phone (206) 362-6331

Other practice location 1

1429 S Broad St
Floor 1
Philadelphia, PA 19147-4919
Phone (215) 468-1425

Other practice location 2

17917 Bothell Everett Hwy Ste 305
Bothell, WA 98012-6379
Phone (425) 481-1038

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
DE60751947WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jieun Choi, DMD, PLLC CurrentSince May 10, 2020 Accepting new patients
Christine H. Kim, D.M.D. Dentist PastSince May 10, 2020 Accepting new patients
Salvatore Pera, DMD, PC Past Accepting new patients

Locations

11066 5th Ave NE
Ste 105
Seattle, WA 98125
Phone (206) 362-6331

Organizations & group practices 3

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": "1274486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588809600000",
    "number": "1053630632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11066 5TH AVE NE STE 105",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981256156",
            "telephone_number": "206-362-6331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11066 5TH AVE NE STE 105",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981256156",
            "telephone_number": "206-362-6331"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1429 S Broad St",
            "address_2": "Floor 1",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191474919",
            "country_code": "US",
            "telephone_number": "215-468-1425",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17917 Bothell Everett Hwy Ste 305",
            "address_purpose": "LOCATION",
            "city": "Bothell",
            "state": "WA",
            "postal_code": "980126379",
            "country_code": "US",
            "telephone_number": "425-481-1038",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHOI",
        "first_name": "JIEUN",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-22",
        "last_updated": "2020-05-07",
        "certification_date": "2020-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60751947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2020; 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.