Provider Demographics
NPI:1053079228
Name:CHON, JAMES JUSTIN (DMD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:JUSTIN
Last Name:CHON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 E CROWTHER AVE UNIT 501
Mailing Address - Street 2:
Mailing Address - City:PLACENTIA
Mailing Address - State:CA
Mailing Address - Zip Code:92870-5672
Mailing Address - Country:US
Mailing Address - Phone:714-864-4594
Mailing Address - Fax:
Practice Address - Street 1:270 E 7TH ST STE 2B
Practice Address - Street 2:
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-6602
Practice Address - Country:US
Practice Address - Phone:909-985-1211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1069181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice