Provider Demographics
NPI:1366563181
Name:CHOE, JENNIFER Y (DDS)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:Y
Last Name:CHOE
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 1:58 W 58TH ST
Mailing Address - Street 2:11C
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-2502
Mailing Address - Country:US
Mailing Address - Phone:646-435-7883
Mailing Address - Fax:732-946-4492
Practice Address - Street 1:146 STATE ROUTE 34
Practice Address - Street 2:
Practice Address - City:HOLMDEL
Practice Address - State:NJ
Practice Address - Zip Code:07733-2407
Practice Address - Country:US
Practice Address - Phone:732-946-4244
Practice Address - Fax:732-946-4492
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ023408001223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics