Provider Demographics
NPI:1285307926
Name:CHOI, REBECCA YENA (DDS)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:YENA
Last Name:CHOI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1814 E ROUTE 66 STE B
Mailing Address - Street 2:
Mailing Address - City:GLENDORA
Mailing Address - State:CA
Mailing Address - Zip Code:91740-3869
Mailing Address - Country:US
Mailing Address - Phone:626-963-7000
Mailing Address - Fax:
Practice Address - Street 1:1814 E ROUTE 66 STE B
Practice Address - Street 2:
Practice Address - City:GLENDORA
Practice Address - State:CA
Practice Address - Zip Code:91740-3869
Practice Address - Country:US
Practice Address - Phone:626-963-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-28
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1063961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice