Provider Demographics
NPI:1427375526
Name:CHO, SOUNGHOON (DDS)
Entity Type:Individual
Prefix:
First Name:SOUNGHOON
Middle Name:
Last Name:CHO
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 1:2700 ALTON PKWY STE 225
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-2646
Mailing Address - Country:US
Mailing Address - Phone:949-253-8300
Mailing Address - Fax:949-253-8303
Practice Address - Street 1:2700 ALTON PKWY STE 225
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-2646
Practice Address - Country:US
Practice Address - Phone:949-253-8300
Practice Address - Fax:949-253-8303
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-28
Last Update Date:2023-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54401122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA26-3377656OtherKMC DENTAL GROUP