Provider Demographics
NPI:1275999070
Name:AUSITN CHOY DDS LLC
Entity Type:Organization
Organization Name:AUSITN CHOY DDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:GH
Authorized Official - Last Name:CHOY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:808-536-4026
Mailing Address - Street 1:50 S BERETANIA ST
Mailing Address - Street 2:SUITE C201
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2208
Mailing Address - Country:US
Mailing Address - Phone:808-536-4026
Mailing Address - Fax:808-524-1081
Practice Address - Street 1:50 S BERETANIA ST
Practice Address - Street 2:SUITE C201
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2208
Practice Address - Country:US
Practice Address - Phone:808-536-4026
Practice Address - Fax:808-524-1081
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-08
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI22661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI058620802Medicaid