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General NPI Number Information
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NPI Number | 1659690451
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Entity Type | Individual
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Provider Name | JAE YONG CHOI JAE CHOI, DDS
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Gender | Female
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Dates
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Enumeration Date | 05/19/2010
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Last Update Date | 09/12/2010
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Provider Practice Location Address
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Address Line | 26910 NEWPORT RD SUITE B
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City | MENIFEE
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State | CA
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Zip | 92584-9080
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Country | US
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Telephone | 951-672-7878
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Fax |
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Provider Business Mailing Address
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Address Line | 27490 GLENWOOD DR
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City | MISSION VIEJO
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State | CA
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Zip | 92692-5005
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Country | US
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Telephone | 310-593-1130
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 56939
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License Number State | CA
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