Provider Demographics
NPI:1699864348
Name:CHOI, ANDREA K (DDS)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:K
Last Name:CHOI
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10570 FOOTHILL BLVD STE 240
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91730-3876
Mailing Address - Country:US
Mailing Address - Phone:909-948-2000
Mailing Address - Fax:909-948-2002
Practice Address - Street 1:10570 FOOTHILL BLVD STE 240
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91730-3876
Practice Address - Country:US
Practice Address - Phone:909-948-2000
Practice Address - Fax:909-948-2002
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2021-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC11916171100000X
CA417151223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No171100000XOther Service ProvidersAcupuncturist