Provider Demographics
NPI:1891475158
Name:CHOI, MINHO (DDS)
Entity type:Individual
Prefix:
First Name:MINHO
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 1:122 FIRST ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141
Mailing Address - Country:US
Mailing Address - Phone:617-621-9500
Mailing Address - Fax:
Practice Address - Street 1:122 FIRST ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02141
Practice Address - Country:US
Practice Address - Phone:617-621-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-21
Last Update Date:2025-07-21
Deactivation Date:2024-02-28
Deactivation Code:
Reactivation Date:2024-10-16
Provider Licenses
StateLicense IDTaxonomies
MADN100009251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice