Individual provider Active NPI

Sunwoong Steve Choi, DDS, MD

  • Oral and Maxillofacial Surgery (Dentist)
  • Los Angeles, CA
National Provider Identifier
1457435588
Registry record updated Jul 20, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
59175 Issued in CA
Practice address
12121 Wilshire Blvd Ste 1111
Frontier Dental Management
Los Angeles, CA 90025-1188
Phone
(310) 820-9933
Fax
(310) 820-0408
NPI assigned
Oct 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2010

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30022305 OH
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 59175 CA Primary

Addresses

Primary practice location

12121 Wilshire Blvd Ste 1111
Frontier Dental Management
Los Angeles, CA 90025-1188

Mailing address

15260 Fairgrove Ave
La Puente, CA 91744-1067
Phone (323) 459-9609

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150714000213 CA Order and Referring Only - Maxillofacial SurgeryPractitioner - Maxillofacial Surgery 3375856834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
30022305OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Duc M. Doan, D.D.S., Inc. Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1279584000000",
    "number": "1457435588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15260 FAIRGROVE AVE",
            "city": "LA PUENTE",
            "state": "CA",
            "postal_code": "917441067",
            "telephone_number": "323-459-9609",
            "fax_number": "626-917-1783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12121 WILSHIRE BLVD STE 1111",
            "address_2": "FRONTIER DENTAL MANAGEMENT",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900251188",
            "telephone_number": "310-820-9933",
            "fax_number": "310-820-0408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "SUNWOONG",
        "middle_name": "STEVE",
        "name_prefix": "Dr.",
        "credential": "DDS, MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-25",
        "last_updated": "2010-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30022305",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "59175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.