Active NPI
Mike Wansik Choe, DDS PA
- General Practice Dentistry
- Fayetteville, NC
National Provider Identifier
1831279256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 6412
- Practice address
- 265 Westlake Rd
Fayetteville, NC 28314-4800 - Phone
- (910) 864-2944
- Fax
- (910) 864-1493
- NPI assigned
- Oct 17, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 6412 | NC | Primary |
Addresses
Primary practice location
265 Westlake Rd
Fayetteville, NC 28314-4800
Mailing address
265 Westlake Rd
Fayetteville, NC 28314-4800
Phone (910) 864-2944
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)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6412 | NC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161043200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461196800000",
"number": "1831279256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "265 WESTLAKE RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283144800",
"telephone_number": "910-864-2944",
"fax_number": "910-864-1493"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "265 WESTLAKE RD",
"city": "FAYETTEVILLE",
"state": "NC",
"postal_code": "283144800",
"telephone_number": "910-864-2944",
"fax_number": "910-864-1493"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHOE",
"first_name": "MIKE",
"middle_name": "WANSIK",
"name_prefix": "Dr.",
"credential": "DDS PA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-17",
"last_updated": "2016-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NC",
"license": "6412",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fayetteville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.