Provider Demographics
NPI:1417067554
Name:H. ELAINE CHEONG, D.D.S., L.L.C.
Entity Type:Organization
Organization Name:H. ELAINE CHEONG, D.D.S., L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HU
Authorized Official - Middle Name:Y 'ELAINE'
Authorized Official - Last Name:CHEONG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:573-499-0300
Mailing Address - Street 1:201 W BROADWAY
Mailing Address - Street 2:BUILDING 2, SUITE A
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-3842
Mailing Address - Country:US
Mailing Address - Phone:573-499-0300
Mailing Address - Fax:573-499-9088
Practice Address - Street 1:201 W BROADWAY
Practice Address - Street 2:BUILDING 2, SUITE A
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-3842
Practice Address - Country:US
Practice Address - Phone:573-499-0300
Practice Address - Fax:573-499-9088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20001435911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty