Active NPI
Myung Soo Choi, DDS
- Periodontics
- Carrollton, TX
National Provider Identifier
1396040705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 25816
- Practice address
- 1017 E Trinity Mills Rd
#102
Carrollton, TX 75006-1438 - Phone
- (909) 471-3782
- NPI assigned
- Jan 14, 2011
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 25816 | TX | Primary |
Addresses
Primary practice location
1017 E Trinity Mills Rd
#102
Carrollton, TX 75006-1438
Mailing address
620 N Coppell Rd
#3602
Coppell, TX 75019-2044
Phone (909) 471-3782
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
| License | State | Type | Specialty |
|---|---|---|---|
| 25816 | TX | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1335225600000",
"number": "1396040705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 N COPPELL RD",
"address_2": "#3602",
"city": "COPPELL",
"state": "TX",
"postal_code": "750192044",
"telephone_number": "909-471-3782"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1017 E TRINITY MILLS RD",
"address_2": "#102",
"city": "CARROLLTON",
"state": "TX",
"postal_code": "750061438",
"telephone_number": "909-471-3782"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHOI",
"first_name": "MYUNG SOO",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2011-01-14",
"last_updated": "2012-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "TX",
"license": "25816",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Carrollton, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.