Individual provider Active NPI

Eunduk Choi, D.D.S.

  • General Practice Dentistry
  • Walla Walla, WA
National Provider Identifier
1619123817
Registry record updated Jun 21, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE60115108 Issued in WA
Practice address
614 E. Alder St.
Suite #3
Walla Walla, WA 99362-2073
Phone
(509) 526-7012
Fax
(509) 526-7013
NPI assigned
Aug 7, 2008
Last updated
Jun 21, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 21, 2013

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 5584 NV
General Practice Dentistry 1223G0001X DE60115108 WA Primary

Addresses

Primary practice location

614 E. Alder St.
Suite #3
Walla Walla, WA 99362-2073

Mailing address

614 E. Alder St.
Suite #3
Walla Walla, WA 99362-2073
Phone (509) 526-7012

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
I20150721001527 WA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3870806722

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5584NVMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Edwards & Choi DDS, Inc. General Practice Past Accepting new patients

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, 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": "1218067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371772800000",
    "number": "1619123817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 E. ALDER ST.",
            "address_2": "SUITE #3",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622073",
            "telephone_number": "509-526-7012",
            "fax_number": "509-526-7013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "614 E. ALDER ST.",
            "address_2": "SUITE #3",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993622073",
            "telephone_number": "509-526-7012",
            "fax_number": "509-526-7013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "EUNDUK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-07",
        "last_updated": "2013-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NV",
            "license": "5584",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60115108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

Verify at the official NPI Registry.