MEDICARE: DR. HAEOH CHOE DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	7178	CO
2	1223G0001X	General Practice Dentistry	8124	NV

General Provider Information

NPI Number	:	1538250196
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HAEOH CHOE DDS

Provider Business Mailing Address
First Line	:	1001 SHADOW LN # MS 7414
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4124
Country	:	US
Telephone Number	:	702-774-2572
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 SHADOW LN # MS 7414
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89106-4124
Country	:	US
Telephone Number	:	702-774-2572
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	12/12/2024

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Directions to “ DR. HAEOH CHOE DDS” Practice Location

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