Provider Demographics
NPI:1588051353
Name:CHOI, CHEOL M. (DMD)
Entity type:Individual
Prefix:
First Name:CHEOL M.
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:244 E ELLENDALE AVE STE 4
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:OR
Mailing Address - Zip Code:97338-1523
Mailing Address - Country:US
Mailing Address - Phone:971-239-1624
Mailing Address - Fax:
Practice Address - Street 1:244 E ELLENDALE AVE STE 4
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-1523
Practice Address - Country:US
Practice Address - Phone:971-239-1624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-20
Last Update Date:2025-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR112081223P0221X
AZ100281223P0221X
AZD0100281223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry