Individual provider Active NPI

James Jun Ho Choi, DDS

  • General Practice Dentistry
  • San Leandro, CA
National Provider Identifier
1083387385
Registry record updated Feb 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
106570 Issued in CA
Practice address
680 Bancroft Ave
San Leandro, CA 94577-2904
Phone
(510) 569-0218
NPI assigned
Aug 1, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 21, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 106570 CA
General Practice Dentistry 1223G0001X DDS106580 CA
General Practice Dentistry 1223G0001X 106570 CA Primary

Addresses

Primary practice location

680 Bancroft Ave
San Leandro, CA 94577-2904

Mailing address

554 62ND St
Oakland, CA 94609-1245

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
DDS106580CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mike Chang DDS Inc Dentist CurrentSince Aug 8, 2021 Accepting new patients
Bancroft Dental Care Dentist PastSince Aug 8, 2021 Accepting new patients

Locations

680 Bancroft Ave
San Leandro, CA 94577
Phone (510) 569-0218

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": "1627776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676937600000",
    "number": "1083387385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "554 62ND ST",
            "city": "OAKLAND",
            "state": "CA",
            "postal_code": "946091245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "680 BANCROFT AVE",
            "city": "SAN LEANDRO",
            "state": "CA",
            "postal_code": "945772904",
            "telephone_number": "510-569-0218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "JAMES",
        "middle_name": "JUN HO",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-01",
        "last_updated": "2023-02-21",
        "certification_date": "2023-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "106570",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS106580",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "106570",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Leandro, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2023; 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.