Provider Demographics
NPI:1457435588
Name:CHOI, SUNWOONG STEVE (DDS, MD)
Entity Type:Individual
Prefix:DR
First Name:SUNWOONG
Middle Name:STEVE
Last Name:CHOI
Suffix:
Gender:M
Credentials:DDS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15260 FAIRGROVE AVE
Mailing Address - Street 2:
Mailing Address - City:LA PUENTE
Mailing Address - State:CA
Mailing Address - Zip Code:91744-1067
Mailing Address - Country:US
Mailing Address - Phone:323-459-9609
Mailing Address - Fax:626-917-1783
Practice Address - Street 1:12121 WILSHIRE BLVD STE 1111
Practice Address - Street 2:FRONTIER DENTAL MANAGEMENT
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-1188
Practice Address - Country:US
Practice Address - Phone:310-820-9933
Practice Address - Fax:310-820-0408
Is Sole Proprietor?:No
Enumeration Date:2006-10-25
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300223051223G0001X
CA591751223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral Practice