Individual provider Active NPI

Paul Kyu Choi, DDS

  • Dentist
  • Portland, OR
National Provider Identifier
1508335993
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D10944 Issued in OR
Practice address
1890 NE 162ND Ave
Portland, OR 97230-5642
Phone
(503) 257-7983
NPI assigned
Nov 15, 2018
Sex
Male
Sole proprietor
No

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

LicenseStateTypeSpecialty
D10944ORMDDentist

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D10944 OR Primary

Addresses

NPPES NPI Registry

Primary practice location

1890 NE 162ND Ave
Portland, OR 97230-5642

Mailing address

13476 NW Bertani St
Portland, OR 97229-8877
Phone (503) 302-2151

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 15, 2018.

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1508335993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13476 NW BERTANI ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972298877",
            "telephone_number": "503-302-2151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1890 NE 162ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972305642",
            "telephone_number": "503-257-7983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "PAUL",
        "middle_name": "KYU",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-15",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.