Individual provider Active NPI

Ellin Jinsun Choi, DDS

  • Pediatric Dentistry
  • Riverside, CA
National Provider Identifier
1942933395
Registry record updated Dec 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
106035 Issued in CA
Practice address
2862 Canyon Springs Pkwy Unit a
Riverside, CA 92507-0928
Phone
(951) 300-2600
NPI assigned
Jul 4, 2022
Last updated
Dec 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Dentistry 1223P0221X 106035 CA Primary

Addresses

Primary practice location

2862 Canyon Springs Pkwy Unit a
Riverside, CA 92507-0928

Mailing address

5300 Trabuco Rd Apt 422
Irvine, CA 92620-5794
Phone (714) 788-6549

Other practice location 1

5300 Trabuco Rd Apt 422
Irvine, CA 92620-5794
Phone (714) 788-6549

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
106035CAMDPediatric Dentist

NPI Registry JSON

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

{
    "created_epoch": "1656892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672185600000",
    "number": "1942933395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 TRABUCO RD APT 422",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926205794",
            "telephone_number": "714-788-6549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2862 CANYON SPRINGS PKWY UNIT A",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925070928",
            "telephone_number": "951-300-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5300 Trabuco Rd Apt 422",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926205794",
            "country_code": "US",
            "telephone_number": "714-788-6549",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHOI",
        "first_name": "ELLIN",
        "middle_name": "JINSUN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-07-04",
        "last_updated": "2022-12-28",
        "certification_date": "2022-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "CA",
            "license": "106035",
            "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 Dec 28, 2022; 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.