Healthcare Provider Details

I. General information

NPI: 1407418072
Provider Name (Legal Business Name): DOHEUM CHOI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2019
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13975 CONNECTICUT AVE STE 208
SILVER SPRING MD
20906-2921
US

IV. Provider business mailing address

13975 CONNECTICUT AVE STE 208
SILVER SPRING MD
20906-2921
US

V. Phone/Fax

Practice location:
  • Phone: 301-598-3951
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number18024
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: