Individual provider Active NPI

Han Choi, DDS

  • Dentist
  • Peoria, AZ
National Provider Identifier
1891040028
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
10108 Issued in AZ
Practice address
20542 N. Lake Pleasant Rd. #113
Peoria, AZ 85382
Phone
(602) 884-8238
Fax
(602) 865-1988
NPI assigned
Jul 13, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 28175 TX
Dentist 122300000X 10108 AZ Primary

Addresses

Primary practice location

20542 N. Lake Pleasant Rd. #113
Peoria, AZ 85382

Mailing address

20542 N. Lake Pleasant Rd. #113
Peoria, AZ 85382
Phone (602) 884-8238

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
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
I20211006001929 AZ Practitioner - Oral SurgeryPractitioner - Dentist 6103186390 Reassigns benefits to 2 organizations
Practice locations: Phoenix, AZ

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10108AZMDDentist
28175TXMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
HC DDS PC CurrentSince Jul 28, 2024 Accepting new patients
TS Dental Management LLC Dentist CurrentSince Aug 17, 2022 Accepting new patients
Ray Road Dmso LLC CurrentSince Aug 17, 2022 Accepting new patients
Han Choi DDS PLLC CurrentSince Jul 30, 2021 Accepting new patients
Familia Dental Lubbock PLLC General Practice PastSince Jun 27, 2021 Accepting new patients

Locations

2900 W Ray Rd
Ste 3
Chandler, AZ 85224
Phone (480) 393-0687

20542 N Lake Pleasant Rd
Ste 113
Peoria, AZ 85382
Phone (602) 884-8238

4530 E Ray Rd
Ste 170
Phoenix, AZ 85044
Phone (480) 477-3090

512 E Southern Ave
Ste 101
Tempe, AZ 85282
Phone (908) 783-2311

Organizations & group practices 5

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": "1342137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1891040028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20542 N. LAKE PLEASANT RD. #113",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "85382",
            "telephone_number": "602-884-8238",
            "fax_number": "602-865-1988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20542 N. LAKE PLEASANT RD. #113",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "85382",
            "telephone_number": "602-884-8238",
            "fax_number": "602-865-1988"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOI",
        "first_name": "HAN",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-13",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "28175",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AZ",
            "license": "10108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peoria, AZ

Sources for this page

Verify at the official NPI Registry.