Provider Demographics
NPI:1235564956
Name:CHO, ELLEN EUN-YOUNG (DDS)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:EUN-YOUNG
Last Name:CHO
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 1:7770 N FRESNO ST
Mailing Address - Street 2:STE. 105
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2412
Mailing Address - Country:US
Mailing Address - Phone:559-431-1772
Mailing Address - Fax:559-431-0506
Practice Address - Street 1:7770 N FRESNO ST
Practice Address - Street 2:STE. 105
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2412
Practice Address - Country:US
Practice Address - Phone:559-431-1772
Practice Address - Fax:559-431-0506
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA627361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice