JC Dental P.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

11856 Issued in GA

Legal business name

JC DENTAL P.C.

Practice address

530 Highland Station Dr
Suite #1006
Suwanee, GA 30024

Phone

(678) 546-2603

Fax

(678) 546-2607

NPI assigned

May 23, 2012

Organization subpart

No

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

Authorized official

Name

Dr. James Choi

Title

President

Phone

(678) 546-2603

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Highland Dental Doing business as

Locations

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337731200000",
    "number": "1982964987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "530 HIGHLAND STATION DR",
            "address_2": "SUITE #1006",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "30024",
            "telephone_number": "678-546-2603",
            "fax_number": "678-546-2607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "530 HIGHLAND STATION DR",
            "address_2": "SUITE #1006",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "30024",
            "telephone_number": "678-546-2603",
            "fax_number": "678-546-2607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JC DENTAL P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-23",
        "last_updated": "2012-05-23",
        "status": "A",
        "authorized_official_last_name": "CHOI",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-546-2603",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "11856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000925889B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Highland Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Suwanee, GA
• Providers in Suwanee, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2012; 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.