Individual provider Active NPI

Jaemi Cho, DDS

  • General Practice Dentistry
  • Anchorage, AK
National Provider Identifier
1740665058
Registry record updated Aug 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
132866 Issued in AK
Practice address
1136 N Muldoon Rd Ste 110
Anchorage, AK 99504
Phone
(907) 333-6666
NPI assigned
Jul 28, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2018

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 31289 TX
General Practice Dentistry 1223G0001X 132866 AK Primary

Addresses

Primary practice location

1136 N Muldoon Rd Ste 110
Anchorage, AK 99504

Mailing address

10844 Anvik Cir
Eagle River, AK 99577-8279
Phone (509) 842-6019

Other practice location 1

8340 Seguin Rd
Unit 2
Converse, TX 78109
Phone (844) 267-2643

Other identifiers 1

IdentifierTypeStateIssuer
1740665058MedicaidTX

Other names 1

  • Jae Mi Cho Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
132866AKMDGeneral Practice Dentistry
31289TXMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1438041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535500800000",
    "number": "1740665058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10844 ANVIK CIR",
            "city": "EAGLE RIVER",
            "state": "AK",
            "postal_code": "995778279",
            "telephone_number": "509-842-6019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1136 N MULDOON RD STE 110",
            "city": "ANCHORAGE",
            "state": "AK",
            "postal_code": "99504",
            "telephone_number": "907-333-6666"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8340 Seguin Rd",
            "address_2": "Unit 2",
            "address_purpose": "LOCATION",
            "city": "Converse",
            "state": "TX",
            "postal_code": "78109",
            "country_code": "US",
            "telephone_number": "844-267-2643",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHO",
        "first_name": "JAEMI",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-28",
        "last_updated": "2018-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "31289",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AK",
            "license": "132866",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1740665058",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAE",
            "last_name": "CHO",
            "middle_name": "MI",
            "credential": "DDS",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Anchorage, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.