Individual provider Active NPI

Andrew Choi, DMD

  • Dentist
  • Yorba Linda, CA
National Provider Identifier
1184268112
Registry record updated Dec 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DDS104374 Issued in CA
Practice address
17300 Yorba Linda Blvd Ste J
Yorba Linda, CA 92886-3810
Phone
(714) 515-6364
NPI assigned
Nov 2, 2019
Last updated
Dec 29, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 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 DDS104374 CA Primary

Addresses

Primary practice location

17300 Yorba Linda Blvd Ste J
Yorba Linda, CA 92886-3810

Mailing address

17300 Yorba Linda Blvd Ste J
Yorba Linda, CA 92886-3810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jun 8, 2023 through Jun 8, 2027

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DDS104374CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Theodore a Tanabe DDS a Professional Corporation PastSince Oct 1, 2023 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: achoi831051@direct.memorialcare.org

Organizations & group practices 1

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": "1572652800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735430400000",
    "number": "1184268112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17300 YORBA LINDA BLVD STE J",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17300 YORBA LINDA BLVD STE J",
            "city": "YORBA LINDA",
            "state": "CA",
            "postal_code": "928863810",
            "telephone_number": "714-515-6364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-02",
        "last_updated": "2024-12-29",
        "certification_date": "2024-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "DDS104374",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yorba Linda, CA

Sources for this page

Verify at the official NPI Registry.