Provider Demographics
NPI:1356605745
Name:CHOI, SUE (DDS, MPH)
Entity type:Individual
Prefix:DR
First Name:SUE
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1685 LOCKBOURNE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43207-1476
Mailing Address - Country:US
Mailing Address - Phone:614-444-9849
Mailing Address - Fax:614-444-0811
Practice Address - Street 1:1685 LOCKBOURNE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43207-1476
Practice Address - Country:US
Practice Address - Phone:614-444-9849
Practice Address - Fax:614-444-0811
Is Sole Proprietor?:No
Enumeration Date:2012-06-29
Last Update Date:2012-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0237251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice