Individual provider Active NPI

Daniel Choi, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Addison, TX
National Provider Identifier
1063709848
Registry record updated Feb 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
27131 Issued in TX
Practice address
3820 Vitruvian Way
#523
Addison, TX 75001-4035
Phone
(614) 390-4090
NPI assigned
Jun 30, 2011
Last updated
Feb 19, 2024By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 19, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X 30-023395 OH
Periodontics 1223P0300X 27131 TX
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 27131 TX Primary

Addresses

Primary practice location

3820 Vitruvian Way
#523
Addison, TX 75001-4035

Mailing address

3820 Vitruvian Way
#523
Addison, TX 75001-4035
Phone (614) 390-4090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240329002774 TX Practitioner - Oral Surgery 8123332244

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30-023395OHMDPeriodontist
27131TXMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
NTDS Grapevine Periodontics CurrentSince Feb 17, 2024 Accepting new patients

Locations

1870 N Stonebridge Dr
#110
McKinney, TX 75071
Phone (214) 592-0692

5949 Dallas Pkwy
Ste 100
Plano, TX 75093
Phone (214) 592-0692

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1309392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708300800000",
    "number": "1063709848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3820 VITRUVIAN WAY",
            "address_2": "#523",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014035",
            "telephone_number": "614-390-4090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3820 VITRUVIAN WAY",
            "address_2": "#523",
            "city": "ADDISON",
            "state": "TX",
            "postal_code": "750014035",
            "telephone_number": "614-390-4090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-30",
        "last_updated": "2024-02-19",
        "certification_date": "2024-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "OH",
            "license": "30-023395",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "TX",
            "license": "27131",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "TX",
            "license": "27131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Addison, TX

Sources for this page

Verify at the official NPI Registry.