Provider Demographics
NPI:1902006745
Name:LUKE K. CHOI, DDS, MS, INC.
Entity Type:Organization
Organization Name:LUKE K. CHOI, DDS, MS, INC.
Other - Org Name:CALIFORNIA DENTISTRY & BRACES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:LUKE
Authorized Official - Middle Name:KYOUNG GOO
Authorized Official - Last Name:CHOI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-947-9500
Mailing Address - Street 1:15862 IMPERIAL HWY
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-2512
Mailing Address - Country:US
Mailing Address - Phone:562-947-9500
Mailing Address - Fax:
Practice Address - Street 1:15862 IMPERIAL HWY
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-2512
Practice Address - Country:US
Practice Address - Phone:562-947-9500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA34316122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty