Provider Demographics
NPI:1104075464
Name:CHOI, NARA (DDS)
Entity type:Individual
Prefix:DR
First Name:NARA
Middle Name:
Last Name:CHOI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:NARA
Other - Middle Name:
Other - Last Name:KIM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:4713 RHAPSODY DR
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91377-5534
Mailing Address - Country:US
Mailing Address - Phone:917-288-6027
Mailing Address - Fax:
Practice Address - Street 1:4849 FM 1488 RD STE 800
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-4558
Practice Address - Country:US
Practice Address - Phone:832-521-8448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-11
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0539571223G0001X
GADN1229481223G0001X
TX41003122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice