Provider Demographics
NPI:1174184220
Name:CHO, SOO HYE (DMD)
Entity Type:Individual
Prefix:DR
First Name:SOO HYE
Middle Name:
Last Name:CHO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4080 LAFAYETTE CENTER DR STE 160-B
Mailing Address - Street 2:
Mailing Address - City:CHANTILLY
Mailing Address - State:VA
Mailing Address - Zip Code:20151-1247
Mailing Address - Country:US
Mailing Address - Phone:703-230-1000
Mailing Address - Fax:
Practice Address - Street 1:2435 MANDEVILLE LANE
Practice Address - Street 2:SUITE 230
Practice Address - City:ALEXANDRIA
Practice Address - State:VA
Practice Address - Zip Code:22332
Practice Address - Country:US
Practice Address - Phone:571-438-3014
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-27
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014173841223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry