Individual provider Active NPI

Sue Jeong Choi, DDS

  • Pediatric Dentistry
  • Bellevue, WA
National Provider Identifier
1508012063
Registry record updated Feb 4, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
DE00010713 Issued in WA
Practice address
5204 Somerset Dr SE
Bellevue, WA 98006-4259
Phone
(415) 218-8811
NPI assigned
Aug 14, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 4, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X DE00010713 WA Primary

Addresses

Primary practice location

5204 Somerset Dr SE
Bellevue, WA 98006-4259

Mailing address

5204 Somerset Dr SE
Bellevue, WA 98006-4259
Phone (415) 218-8811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20150618002472 WA Order and Referring Only - DentistPractitioner - Dentist 6305157215

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE00010713WAMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sue J Choi DDS PLLC Pediatric Dentistry Current Accepting new patients

Locations

4122 Factoria Blvd SE
Ste 100
Bellevue, WA 98006
Phone (425) 800-5001

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": "1218672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517702400000",
    "number": "1508012063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5204 SOMERSET DR SE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980064259",
            "telephone_number": "415-218-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5204 SOMERSET DR SE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980064259",
            "telephone_number": "415-218-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "SUE",
        "middle_name": "JEONG",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-14",
        "last_updated": "2018-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "WA",
            "license": "DE00010713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellevue, WA

Sources for this page

Verify at the official NPI Registry.