Healthcare Provider Details

I. General information

NPI: 1144069899
Provider Name (Legal Business Name): WON JOON CHOI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: JOHN CHOI

II. Dates (important events)

Enumeration Date: 05/22/2024
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1219 FOREST AVE STE G
PACIFIC GROVE CA
93950-5136
US

IV. Provider business mailing address

1219 FOREST AVE STE G
PACIFIC GROVE CA
93950-5136
US

V. Phone/Fax

Practice location:
  • Phone: 831-373-7575
  • Fax:
Mailing address:
  • Phone: 831-373-7575
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number112851
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: