Active NPI
Carissa Choong
- General Practice Dentistry
- Ann Arbor, MI
National Provider Identifier
1114548112
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 2951000802
- Practice address
- 1011 N University Ave
Ann Arbor, MI 48109-1078 - Phone
- (734) 647-4166
- Fax
- (734) 615-7294
- NPI assigned
- Apr 30, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 2951000802 | MI | Primary |
Addresses
Primary practice location
1011 N University Ave
Ann Arbor, MI 48109-1078
Mailing address
1011 N University Ave
Ann Arbor, MI 48109-1078
Phone (734) 647-4166
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 |
|---|---|---|---|
| 2951000802 | MI | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1588204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1588204800000",
"number": "1114548112",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 N UNIVERSITY AVE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481091078",
"telephone_number": "734-647-4166",
"fax_number": "734-615-7294"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1011 N UNIVERSITY AVE",
"city": "ANN ARBOR",
"state": "MI",
"postal_code": "481091078",
"telephone_number": "734-647-4166",
"fax_number": "734-615-7294"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHOONG",
"first_name": "CARISSA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-04-30",
"last_updated": "2020-04-30",
"certification_date": "2020-04-30",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "MI",
"license": "2951000802",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ann Arbor, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.