NPIMap

Individual provider Active NPI

Otto Myungho Choi, DDS

  • Pediatric Dentistry
  • Newark, NJ
National Provider Identifier
1285895789
Registry record updated Jan 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
22DI02426000 Issued in NJ
Practice address
66 Somme St
Newark, NJ 07105-3612
Phone
(973) 578-8788
Fax
(973) 578-8799
NPI assigned
Jun 18, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 17, 2018

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 054429-1 NY
Pediatric Dentistry 1223P0221X 22DI02426001 NJ
Pediatric Dentistry 1223P0221X 22DI02426005 NJ
Pediatric Dentistry 1223P0221X 22DI02426000 NJ Primary

Addresses

Primary practice location

66 Somme St
Newark, NJ 07105-3612

Mailing address

345 Old Hook Rd
Westwood, NJ 07675-3201
Phone (201) 345-7745

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

LicenseStateTypeSpecialty
22DI02426000NJMDPediatric Dentist
22DI02426001NJMDPediatric Dentist
22DI02426005NJMDPediatric Dentist
054429-1NYMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Pearly Whites Spec LLC Past Accepting new patients
Otto M Choi DDS, PC Pediatric Dentistry Past Accepting new patients
Orthique LLC Past Accepting new patients
Childsmiles, PA Past Accepting new patients
Skolnick Dental Associates Inc Pediatric Dentistry PastSince Dec 15, 2019 Accepting new patients
Child Smiles Spec LLC Past Accepting new patients

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1516147200000",
    "number": "1285895789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 OLD HOOK RD",
            "city": "WESTWOOD",
            "state": "NJ",
            "postal_code": "076753201",
            "telephone_number": "201-345-7745",
            "fax_number": "201-345-7745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 SOMME ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071053612",
            "telephone_number": "973-578-8788",
            "fax_number": "973-578-8799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "OTTO",
        "middle_name": "MYUNGHO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2018-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NY",
            "license": "054429-1",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02426001",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02426005",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "22DI02426000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newark, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2018; 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.