Karen Choi
Individual provider Active NPI General Practice Dentistry · Carbondale, IL
NPI 1265832240 · NPPES record last updated Aug 11, 2021
Key facts
- NPI
- 1265832240
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 057489 (NY)
- Practice address
- 1111 E Walnut St Ste B
Carbondale, IL 62901-5000 - Phone
- (618) 529-2571
- NPI assigned
- Aug 27, 2014
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
- Opted out of Medicare
- Yes, effective Aug 20, 2021 through Aug 20, 2027
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019032848 | IL | MD | General Practice Dentistry |
| 057489 | NY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Billy B. Laun II, DDS, PC | Current |
Accepting new patients | |
| Frederick Gustave, D.D.S., PC | Past |
Accepting new patients |
Locations
1111 E Walnut St
Ste B
Carbondale, IL 62901
Phone (618) 529-2571
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 019032848 | IL | |
| General Practice Dentistry | 1223G0001X | 057489 | NY | Yes |
Addresses
Primary practice location
1111 E Walnut St Ste B
Carbondale, IL 62901-5000
Mailing address
1111 E Walnut St Ste B
Carbondale, IL 62901-5000
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- Choices Medical Services, PC
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All providers in Carbondale, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 11, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.