Provider Demographics
NPI:1457240186
Name:CHOTI, PETO (DDS)
Entity type:Individual
Prefix:
First Name:PETO
Middle Name:
Last Name:CHOTI
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 1:3206 ROGUE RIVER DR
Mailing Address - Street 2:
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95973-9548
Mailing Address - Country:US
Mailing Address - Phone:530-605-6281
Mailing Address - Fax:
Practice Address - Street 1:2630 OLIVE HWY STE A
Practice Address - Street 2:
Practice Address - City:OROVILLE
Practice Address - State:CA
Practice Address - Zip Code:95966-6138
Practice Address - Country:US
Practice Address - Phone:530-534-6666
Practice Address - Fax:530-534-1040
Is Sole Proprietor?:No
Enumeration Date:2025-06-30
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA111833122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist