Individual provider Active NPI

Raymond Y Choi, D.D.S.

  • Dentist
  • Tustin, CA
National Provider Identifier
1063842029
Registry record updated Nov 12, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
35383 Issued in CA
Practice address
17502 W. Irvine Blvd
Suite B
Tustin, CA 92780
Phone
(714) 838-1111
Fax
(714) 838-1213
NPI assigned
Nov 12, 2013
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 12, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 35383 CA Primary

Addresses

Primary practice location

17502 W. Irvine Blvd
Suite B
Tustin, CA 92780

Mailing address

17502 W. Irvine Blvd
Suite B
Tustin, CA 92780
Phone (714) 838-1111

Other identifiers 2

IdentifierTypeStateIssuer
1952521932OtherCATYPE 1
1952521932OtherTYPE 1

Other names 1

  • Dr. Raymond Y Choi Professional 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)
Enrolled

State licenses

LicenseStateTypeSpecialty
35383CAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1384214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1384214400000",
    "number": "1063842029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17502 W. IRVINE BLVD",
            "address_2": "SUITE B",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "92780",
            "telephone_number": "714-838-1111",
            "fax_number": "714-838-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17502 W. IRVINE BLVD",
            "address_2": "SUITE B",
            "city": "TUSTIN",
            "state": "CA",
            "postal_code": "92780",
            "telephone_number": "714-838-1111",
            "fax_number": "714-838-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "RAYMOND",
        "middle_name": "Y",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-11-12",
        "last_updated": "2013-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "35383",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1",
            "identifier": "1952521932",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE 1",
            "identifier": "1952521932",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "RAYMOND",
            "last_name": "CHOI",
            "middle_name": "Y",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Tustin, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2013; 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.