Provider Demographics
NPI:1538550967
Name:CHOI, JOSEPH JONG IL (DDS)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JONG IL
Last Name:CHOI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9603 CUSTER RD APT 1525
Mailing Address - Street 2:
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75025-6518
Mailing Address - Country:US
Mailing Address - Phone:865-809-8489
Mailing Address - Fax:
Practice Address - Street 1:6300 WEST LOOP S STE 650
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-2997
Practice Address - Country:US
Practice Address - Phone:713-457-3445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-06
Last Update Date:2015-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX306861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice