Individual provider Active NPI

Hyeonju Choi, D.M.D

  • Dentist
  • Irvine, CA
National Provider Identifier
1396953949
Registry record updated May 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
46042 Issued in CA
Practice address
113 Waterworks Way
120
Irvine, CA 92618-3167
Phone
(949) 786-2820
NPI assigned
May 18, 2007
Last updated
May 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 46042 CA Primary

Addresses

Primary practice location

113 Waterworks Way
120
Irvine, CA 92618-3167

Mailing address

113 Waterworks Way
Suite 120
Irvine, CA 92618-3167
Phone (949) 786-2820

Other names 1

  • Dr. Michael Choi Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150223000968 CA Practitioner - Oral Surgery 4385967009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
46042CAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Choi Dental Corporation CurrentSince Dec 29, 2014 Accepting new patients

Locations

113 Waterworks Way
Ste 120
Irvine, CA 92618
Phone (949) 786-2820

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464220800000",
    "number": "1396953949",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 WATERWORKS WAY",
            "address_2": "SUITE 120",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183167",
            "telephone_number": "949-786-2820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 WATERWORKS WAY",
            "address_2": "120",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183167",
            "telephone_number": "949-786-2820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "HYEONJU",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2016-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "46042",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHAEL",
            "last_name": "CHOI",
            "prefix": "DR.",
            "credential": "D.M.D",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Irvine, CA

Sources for this page

Verify at the official NPI Registry.