Provider Demographics
NPI:1750444154
Name:CHOI, YOON S (DMD)
Entity type:Individual
Prefix:DR
First Name:YOON
Middle Name:S
Last Name:CHOI
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18692 LA CASITA AVE
Mailing Address - Street 2:
Mailing Address - City:YORBA LINDA
Mailing Address - State:CA
Mailing Address - Zip Code:92886-2540
Mailing Address - Country:US
Mailing Address - Phone:734-929-9910
Mailing Address - Fax:734-929-6623
Practice Address - Street 1:4600 WASHTENAW AVE
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48108-1302
Practice Address - Country:US
Practice Address - Phone:734-929-9910
Practice Address - Fax:734-929-6623
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-18
Last Update Date:2021-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010174271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice