Provider Demographics
NPI:1063709848
Name:CHOI, DANIEL (DDS)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:
Last Name:CHOI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3820 VITRUVIAN WAY
Mailing Address - Street 2:#523
Mailing Address - City:ADDISON
Mailing Address - State:TX
Mailing Address - Zip Code:75001-4035
Mailing Address - Country:US
Mailing Address - Phone:614-390-4090
Mailing Address - Fax:
Practice Address - Street 1:3820 VITRUVIAN WAY
Practice Address - Street 2:#523
Practice Address - City:ADDISON
Practice Address - State:TX
Practice Address - Zip Code:75001-4035
Practice Address - Country:US
Practice Address - Phone:614-390-4090
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-30
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0233951223P0300X
TX271311223P0300X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223P0300XDental ProvidersDentistPeriodontics