Victor Lee Chou, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN 21203 Issued in FL

Practice address

11900 Atlantic Blvd Unit 1
Jacksonville, FL 32225-2920

Phone

(479) 371-2094

NPI assigned

Jun 8, 2015

Last updated

Dec 12, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Networks

• Freedom Health HMO Network

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

{
    "created_epoch": "1433721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1558741249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 SW 8TH ST",
            "city": "BENTONVILLE",
            "state": "AR",
            "postal_code": "727160445",
            "telephone_number": "352-222-2765"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11900 ATLANTIC BLVD UNIT 1",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322252920",
            "telephone_number": "479-371-2094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOU",
        "first_name": "VICTOR",
        "middle_name": "LEE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-08",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN 21203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "019541100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shruti Chopra, DDS
• Alyssa Jordan Choquette
• Chosenkare Transporting LLC
• Kan Chotinanda, PHARMD
• Alaina Chou, PHARMD
• Hamza Aftab Choudhry
• Lila K Choulat, CNM
• Konstantinos Chouliaras, M.D.
• Meredith Chouliaras, CRNA
• Bhakti Chourasia, MD

• General Practice Dentistry in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.