Provider Demographics
NPI:1073094652
Name:CHOE, DAVID PHOON (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:DAVID PHOON
Middle Name:
Last Name:CHOE
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18930 CARMENITA RD STE D
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703-6379
Mailing Address - Country:US
Mailing Address - Phone:562-402-2535
Mailing Address - Fax:562-403-6821
Practice Address - Street 1:113 WATERWORKS WAY STE 215
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-3176
Practice Address - Country:US
Practice Address - Phone:949-754-9004
Practice Address - Fax:949-754-9077
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-22
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA373201223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty