Eunjung J. Jung Choi, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

63502 Issued in CA

Practice address

300 S Highland Springs Ave Ste 2L
Banning, CA 92220

Phone

(951) 769-7158

NPI assigned

Nov 13, 2014

Last updated

Dec 6, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Jung Choi DDS Inc

  • General Practice Dentistry
  • Banning, CA
  • NPI 1336628361
  NPD Authorized official

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

{
    "created_epoch": "1415836800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1639575962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 S HIGHLAND SPRINGS AVE STE 2L",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "922206503",
            "telephone_number": "951-769-7158",
            "fax_number": "951-769-7160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 S HIGHLAND SPRINGS AVE STE 2L",
            "city": "BANNING",
            "state": "CA",
            "postal_code": "92220",
            "telephone_number": "951-769-7158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "EUNJUNG",
        "middle_name": "J. JUNG",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-11-13",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "63502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joey Chen
• Cherry Valley SNF Healthcare, LLC (Sundance Creek Post Acute)
• Jaime Kay Cherry, EDD
• Joleen Faye Chiachi Estrada
• John Choe, DDS
• Joshua Hyung Choi, M.D.
• Sungjo J Choi, D.D.S.
• Myette L Christian, MFTT
• Ludwig J Cibelli, M.D
• City of Banning

• General Practice Dentistry in Banning, CA
• Providers in Banning, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.