Healthcare Provider Details

I. General information

NPI: 1215947072
Provider Name (Legal Business Name): WILLIAM CHOI DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

447 W DUSSEL DR
MAUMEE OH
43537-4208
US

IV. Provider business mailing address

11 S MILL ST STE 200
NEW CASTLE PA
16101-3680
US

V. Phone/Fax

Practice location:
  • Phone: 419-740-6175
  • Fax:
Mailing address:
  • Phone: 419-973-1725
  • Fax: 419-841-7833

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30022326
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30022326
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number052749
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: