Individual provider Active NPI

Kyo Min Choo, D.M.D

  • Dentist
  • Baltimore, MD
National Provider Identifier
1467967463
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
16659 Issued in MD
Practice address
6532 Reisterstown Rd
Baltimore, MD 21215-2304
Phone
(410) 585-0010
NPI assigned
Dec 13, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 16659 MD Primary

Addresses

Primary practice location

6532 Reisterstown Rd
Baltimore, MD 21215-2304

Mailing address

6532 Reisterstown Rd
Baltimore, MD 21215-2304
Phone (410) 585-0010

Other practice location 1

2401 Belair Rd Ste 104
Baltimore, MD 21213-1200
Phone (410) 522-5777

Other practice location 2

4510 Edmondson Ave
Baltimore, MD 21229-1506
Phone (410) 233-5777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD
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
I20180515002131 MD Order and Referring Only - DentistPractitioner - Dentist 2860756079

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Dental Dreams, LLC PastSince Dec 22, 2020 Accepting new patients
Dental Dreams, LLC Past Accepting new patients

Organizations & group practices 2

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": "1513123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1467967463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6532 REISTERSTOWN RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212152304",
            "telephone_number": "410-585-0010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6532 REISTERSTOWN RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212152304",
            "telephone_number": "410-585-0010"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2401 Belair Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212131200",
            "country_code": "US",
            "telephone_number": "410-522-5777",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4510 Edmondson Ave",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212291506",
            "country_code": "US",
            "telephone_number": "410-233-5777",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHOO",
        "first_name": "KYO MIN",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-12-13",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "16659",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

Verify at the official NPI Registry.