Active NPI
Jung-Yi Choi
- Dentist
- Santa Rosa, CA
National Provider Identifier
1780873604
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 53585
- Practice address
- 1240 Farmers LN
Santa Rosa, CA 95405-6707 - Phone
- (707) 545-5200
- Fax
- (707) 579-3207
- NPI assigned
- Oct 16, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 53585 | CA | Primary |
Addresses
Primary practice location
1240 Farmers LN
Santa Rosa, CA 95405-6707
Mailing address
4973 Oak Park Way
Santa Rosa, CA 95409-3634
Phone (800) 417-4444
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D53585 | Medicaid | CA |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 53585 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Dental Services, Inc. | 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 and National Provider Directory roles.
-
- General Practice Dentistry
- Santa Rosa, CA
- NPI 1417009598
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1192492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1192492800000",
"number": "1780873604",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4973 OAK PARK WAY",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954093634",
"telephone_number": "800-417-4444",
"fax_number": "714-571-3560"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1240 FARMERS LN",
"city": "SANTA ROSA",
"state": "CA",
"postal_code": "954056707",
"telephone_number": "707-545-5200",
"fax_number": "707-579-3207"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHOI",
"first_name": "JUNG-YI",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-10-16",
"last_updated": "2007-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "53585",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D53585",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Santa Rosa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.