Provider Demographics
NPI:1275778342
Name:HO, ROGER CHENG-HUEH (DDS)
Entity Type:Individual
Prefix:
First Name:ROGER
Middle Name:CHENG-HUEH
Last Name:HO
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 1:2979 FAIRVIEW ROAD
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626
Mailing Address - Country:US
Mailing Address - Phone:714-979-3970
Mailing Address - Fax:714-662-7798
Practice Address - Street 1:2979 FAIRVIEW RD
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4117
Practice Address - Country:US
Practice Address - Phone:714-979-3970
Practice Address - Fax:714-662-7798
Is Sole Proprietor?:No
Enumeration Date:2008-12-03
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD74691223G0001X
CA506071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice