NPIMap

Organization Active NPI

Good Choi's Dental Care, P.C.

  • General Practice Dentistry
  • Manassas, VA
National Provider Identifier
1265818363
Registry record updated Jul 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
0401411171 Issued in VA
Legal business name
GOOD CHOI'S DENTAL CARE, P.C.
Practice address
10555 Crestwood Dr., Unit B
Manassas, VA 20109
Phone
(571) 234-2831
NPI assigned
Jul 31, 2015
Last updated
Jul 31, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2015

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

Authorized official

Name
Dr. Sungwon Choi, D.M.D.
Title
General Dentist/Clinic Owner
Phone
(571) 234-2831

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401411171 VA Primary

Addresses

Primary practice location

10555 Crestwood Dr., Unit B
Manassas, VA 20109

Mailing address

10555 Crestwood Dr., Unit B
Manassas, VA 20109
Phone (571) 234-2831

Other identifiers 1

IdentifierTypeStateIssuer
1093879280MedicaidVA

National Provider Directory

National Provider Directory

Locations

10555 Crestwood Dr
Ste B
Manassas, VA 20109
Phone (571) 234-2831

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1438300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438300800000",
    "number": "1265818363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10555 CRESTWOOD DR., UNIT B",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "20109",
            "telephone_number": "571-234-2831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10555 CRESTWOOD DR., UNIT B",
            "city": "MANASSAS",
            "state": "VA",
            "postal_code": "20109",
            "telephone_number": "571-234-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOOD CHOI'S DENTAL CARE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-07-31",
        "last_updated": "2015-07-31",
        "status": "A",
        "authorized_official_last_name": "CHOI",
        "authorized_official_first_name": "SUNGWON",
        "authorized_official_title_or_position": "GENERAL DENTIST/CLINIC OWNER",
        "authorized_official_telephone_number": "571-234-2831",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401411171",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1093879280",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manassas, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; 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.