Provider Demographics
NPI:1326284951
Name:SOHN, JOHANNA HYUNKYUNG (DDS)
Entity Type:Individual
Prefix:
First Name:JOHANNA
Middle Name:HYUNKYUNG
Last Name:SOHN
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 1:7670 PARKER ROAD
Mailing Address - Street 2:
Mailing Address - City:FORT RILEY
Mailing Address - State:KS
Mailing Address - Zip Code:66442-4247
Mailing Address - Country:US
Mailing Address - Phone:785-239-4261
Mailing Address - Fax:
Practice Address - Street 1:7670 PARKER ST
Practice Address - Street 2:
Practice Address - City:FORT RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442-4247
Practice Address - Country:US
Practice Address - Phone:785-239-4261
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-03
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401-4123411223G0001X, 1223G0001X
VA4014123411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice