Individual provider Active NPI

Yon Choi

  • General Practice Dentistry
  • Tukwila, WA
National Provider Identifier
1598318255
Registry record updated Nov 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE61311634 Issued in WA
Practice address
16400 Southcenter Pkwy Ste 103
Tukwila, WA 98188-3330
Phone
(206) 575-0400
NPI assigned
Jul 22, 2019
Last updated
Nov 21, 2022By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2022

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 104115 CA
General Practice Dentistry 1223G0001X DE61311634 WA Primary

Addresses

Primary practice location

16400 Southcenter Pkwy Ste 103
Tukwila, WA 98188-3330

Mailing address

16400 Southcenter Pkwy Ste 103
Tukwila, WA 98188-3330
Phone (206) 575-0400

Other practice location 1

435 4th Ave
San Diego, CA 92101-6234
Phone (619) 850-2550

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190911003057 CA Order and Referring Only - DentistPractitioner - Dentist 5496084774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DE61311634WAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Nurani, Mitchell, Kim, PC PastSince Nov 27, 2022 Accepting new patients
Downtown SD Modern Dentistry Dental Group PastSince Jul 28, 2019 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668988800000",
    "number": "1598318255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16400 SOUTHCENTER PKWY STE 103",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981883330",
            "telephone_number": "206-575-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16400 SOUTHCENTER PKWY STE 103",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981883330",
            "telephone_number": "206-575-0400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "435 4th Ave",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921016234",
            "country_code": "US",
            "telephone_number": "619-850-2550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHOI",
        "first_name": "YON",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-22",
        "last_updated": "2022-11-21",
        "certification_date": "2022-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104115",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE61311634",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tukwila, WA

Sources for this page

Verify at the official NPI Registry.