Active NPI
James Jun Ho Choi, DDS
- General Practice Dentistry
- San Leandro, CA
National Provider Identifier
1083387385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 106570
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| DDS106580 | CA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mike Chang DDS Inc | Dentist | Current | Accepting new patients |
| Bancroft Dental Care | Dentist | Past | 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.
-
- Dentist
- San Leandro, CA
- NPI 1881933190
-
- Dentist
- San Leandro, CA
- NPI 1659725240
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.