Provider Demographics
NPI:1801935994
Name:CHOI, SANG DON (DDS)
Entity type:Individual
Prefix:DR
First Name:SANG
Middle Name:DON
Last Name:CHOI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:SANG
Other - Middle Name:DON
Other - Last Name:CHOI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:711 S VERMONT AVE
Mailing Address - Street 2:#111
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90005-1519
Mailing Address - Country:US
Mailing Address - Phone:213-387-2325
Mailing Address - Fax:213-387-0910
Practice Address - Street 1:711 S VERMONT AVE
Practice Address - Street 2:#111
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90005-1519
Practice Address - Country:US
Practice Address - Phone:213-387-2325
Practice Address - Fax:213-387-0910
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA370901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice