Individual provider Active NPI

Junho Choi, DMD

  • Dentist
  • Palm Desert, CA
National Provider Identifier
1063895050
Registry record updated Jan 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.024554 Issued in OH
Practice address
74133 El Paseo Ste D
Palm Desert, CA 92260-4123
Phone
(760) 346-8056
NPI assigned
Jul 8, 2015
Last updated
Jan 4, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.024554 OH Primary

Addresses

Primary practice location

74133 El Paseo Ste D
Palm Desert, CA 92260-4123

Mailing address

296 Paseo Vista Cir
Palm Desert, CA 92260-5294
Phone (502) 526-6858

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160928001959 OH Order and Referring Only - DentistPractitioner - Dentist 1355638719

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.024554OHMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Dell'Acqua Choi Dental Partnership CurrentSince Jan 7, 2024 Accepting new patients
Junho Choi DMD Inc CurrentSince May 19, 2024 Accepting new patients
Mark T Bentley DDS Inc Past Accepting new patients
Dental Implant Center of Ohio Dentist PastSince May 1, 2021 Accepting new patients
Junho Choi Dental Corporation PastSince Oct 9, 2022 Accepting new patients
Junho Dentistry, LLC Dentist PastSince May 1, 2021 Accepting new patients

Locations

74133 El Paseo
Ste D
Palm Desert, CA 92260
Phone (760) 346-8056

Organizations & group practices 6

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": "1436313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704326400000",
    "number": "1063895050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "296 PASEO VISTA CIR",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922605294",
            "telephone_number": "502-526-6858"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74133 EL PASEO STE D",
            "city": "PALM DESERT",
            "state": "CA",
            "postal_code": "922604123",
            "telephone_number": "760-346-8056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "JUNHO",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-07-08",
        "last_updated": "2024-01-04",
        "certification_date": "2024-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.024554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Palm Desert, CA

Sources for this page

Verify at the official NPI Registry.