Provider Demographics
NPI:1932328200
Name:CHOI, JAMES JOONCHUL (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JOONCHUL
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 1:530 HIGHLAND STATION DR
Mailing Address - Street 2:#1006
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-6571
Mailing Address - Country:US
Mailing Address - Phone:678-546-2603
Mailing Address - Fax:678-546-2607
Practice Address - Street 1:530 HIGHLAND STATION DR
Practice Address - Street 2:#1006
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6571
Practice Address - Country:US
Practice Address - Phone:678-546-2603
Practice Address - Fax:678-546-2607
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2012-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA118561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000925889BMedicaid