Individual provider Active NPI

Sung Gyu Choi, DDS

  • Dentist
  • Totowa, NJ
National Provider Identifier
1609394469
Registry record updated Sep 16, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02721500 Issued in NJ
Practice address
418 Union Blvd
Totowa, NJ 07512-2562
Phone
(973) 595-5955
NPI assigned
Aug 31, 2017
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02721500 NJ Primary

Addresses

Primary practice location

418 Union Blvd
Totowa, NJ 07512-2562

Mailing address

418 Union Blvd
Totowa, NJ 07512-2562
Phone (973) 595-5955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20171017000896 CT Order and Referring Only - DentistPractitioner - Dentist 6305112574

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22DI02721500NJMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Best Choice Dental PC CurrentSince Jun 16, 2024 Accepting new patients
Hamden Plaza Family Dental, PC PastSince Oct 2, 2022 Accepting new patients
Dr. Dental of Connecticut, PC Past Accepting new patients

Locations

418 Union Blvd
Totowa, NJ 07512
Phone (973) 595-5955

Organizations & group practices 3

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": "1504137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631750400000",
    "number": "1609394469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "418 UNION BLVD",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075122562",
            "telephone_number": "973-595-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "418 UNION BLVD",
            "city": "TOTOWA",
            "state": "NJ",
            "postal_code": "075122562",
            "telephone_number": "973-595-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "SUNG GYU",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-08-31",
        "last_updated": "2021-09-16",
        "certification_date": "2021-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02721500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Totowa, NJ

Sources for this page

Verify at the official NPI Registry.