Provider Demographics
NPI:1962661728
Name:CHOI, MIJIN (DDS,MS,FACP)
Entity Type:Individual
Prefix:DR
First Name:MIJIN
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:DDS,MS,FACP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:726 BROADWAY STE 350
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-9616
Mailing Address - Country:US
Mailing Address - Phone:212-443-1322
Mailing Address - Fax:212-443-1331
Practice Address - Street 1:726 BROADWAY STE 350
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-9616
Practice Address - Country:US
Practice Address - Phone:212-443-1322
Practice Address - Fax:212-443-1331
Is Sole Proprietor?:No
Enumeration Date:2008-06-06
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0518871223X0400X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics