Individual provider Active NPI

Andrew Seon Choi, DDS

  • General Practice Dentistry
  • Riverside, CA
National Provider Identifier
1790318558
Registry record updated Feb 19, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
104807 Issued in CA
Practice address
6216 Brockton Ave Ste 112
Riverside, CA 92506-2208
Phone
(951) 779-8862
NPI assigned
Feb 19, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 104807 CA Primary

Addresses

Primary practice location

6216 Brockton Ave Ste 112
Riverside, CA 92506-2208

Mailing address

33427 Gold Gulch Way
Yucaipa, CA 92399-6948

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
104807CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Inland Choice Dental Partnership General Practice Current Accepting new patients
Davi Y Choi DDS Corp General Practice CurrentSince Aug 14, 2022 Accepting new patients

Locations

6216 Brockton Ave
Ste 112
Riverside, CA 92506
Phone (951) 779-8862

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582070400000",
    "number": "1790318558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33427 GOLD GULCH WAY",
            "city": "YUCAIPA",
            "state": "CA",
            "postal_code": "923996948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6216 BROCKTON AVE STE 112",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925062208",
            "telephone_number": "951-779-8862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "ANDREW",
        "middle_name": "SEON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-19",
        "last_updated": "2020-02-19",
        "certification_date": "2020-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "104807",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverside, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2020; 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.