Individual provider Active NPI

Bokyu Choi, D.M.D.

  • Dentist
  • Centreville, VA
National Provider Identifier
1366751976
Registry record updated Feb 15, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
0401413070 Issued in VA
Practice address
13890 Braddock Rd
Ste305
Centreville, VA 20121-2435
Phone
(703) 815-2875
Fax
(703) 815-2876
NPI assigned
Sep 29, 2010
Last updated
Feb 15, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DS037760 PA
Dentist 122300000X 0401413070 VA Primary

Addresses

Primary practice location

13890 Braddock Rd
Ste305
Centreville, VA 20121-2435

Mailing address

13890 Braddock Rd
Ste305
Centreville, VA 20121-2435
Phone (703) 815-2875

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
DS037760PAMDDentist
0401413070VAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360886400000",
    "number": "1366751976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13890 BRADDOCK RD",
            "address_2": "STE305",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212435",
            "telephone_number": "703-815-2875",
            "fax_number": "703-815-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13890 BRADDOCK RD",
            "address_2": "STE305",
            "city": "CENTREVILLE",
            "state": "VA",
            "postal_code": "201212435",
            "telephone_number": "703-815-2875",
            "fax_number": "703-815-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "BOKYU",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-09-29",
        "last_updated": "2013-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS037760",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401413070",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centreville, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2013; 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.