Provider Demographics
NPI:1912000852
Name:CHOI, JIMMY K (DDS)
Entity Type:Individual
Prefix:DR
First Name:JIMMY
Middle Name:K
Last Name:CHOI
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 1:10217 LOWER AZUSA RD
Mailing Address - Street 2:
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-4027
Mailing Address - Country:US
Mailing Address - Phone:626-941-6022
Mailing Address - Fax:
Practice Address - Street 1:10217 LOWER AZUSA RD
Practice Address - Street 2:
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-4027
Practice Address - Country:US
Practice Address - Phone:626-941-6022
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA515611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice