Individual provider Active NPI

Mark C Choe, DDS

  • General Practice Dentistry
  • Fairfax, VA
National Provider Identifier
1952592032
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN123752 Issued in GA
Practice address
9528 Fairfax Blvd
Fairfax, VA 22031-4738
Phone
(703) 279-3400
Fax
(703) 766-1374
NPI assigned
Aug 5, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 0401008863 VA
General Practice Dentistry 1223G0001X DN123752 GA Primary

Addresses

Primary practice location

9528 Fairfax Blvd
Fairfax, VA 22031-4738

Mailing address

9528 Fairfax Blvd
Fairfax, VA 22031-4738
Phone (703) 279-3400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20171204001644 PA Order and Referring Only - DentistPractitioner - Dentist 1254577570

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN123752GAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Neibauer Dental Care 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.

NPI Registry JSON

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

{
    "created_epoch": "1186272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1952592032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9528 FAIRFAX BLVD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314738",
            "telephone_number": "703-279-3400",
            "fax_number": "703-766-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9528 FAIRFAX BLVD",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220314738",
            "telephone_number": "703-279-3400",
            "fax_number": "703-766-1374"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHOE",
        "first_name": "MARK",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-05",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "VA",
            "license": "0401008863",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN123752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfax, VA

Sources for this page

Verify at the official NPI Registry.