Individual provider Active NPI

Choolin Khoo, DDS

  • Dentist
  • Glendale, CA
National Provider Identifier
1659403798
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
52735 Issued in CA
Practice address
248 W Loraine St Unit 308
Glendale, CA 91202-3171
Phone
(909) 553-3886
NPI assigned
Mar 12, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 52735 CA Primary

Addresses

Primary practice location

248 W Loraine St Unit 308
Glendale, CA 91202-3171

Mailing address

248 W Loraine St Unit 308
Glendale, CA 91202-3171
Phone (909) 553-3886

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
I20150707002888 CA Order and Referring Only - DentistPractitioner - Dentist 6709198542

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
52735CAMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659403798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "248 W LORAINE ST UNIT 308",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912023171",
            "telephone_number": "909-553-3886"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "248 W LORAINE ST UNIT 308",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912023171",
            "telephone_number": "909-553-3886"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHOO",
        "first_name": "CHOOLIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "52735",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

Verify at the official NPI Registry.