Healthcare Provider Details

I. General information

NPI: 1376761429
Provider Name (Legal Business Name): JOSEPH KYUNGJO CHOI D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 05/21/2026
Certification Date: 05/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9636 GARDEN GROVE BLVD
GARDEN GROVE CA
92844-1530
US

IV. Provider business mailing address

670 S GENTRY LN
ANAHEIM CA
92807-3653
US

V. Phone/Fax

Practice location:
  • Phone: 714-590-2828
  • Fax:
Mailing address:
  • Phone: 714-356-8373
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDDS54345
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number019-023417
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: