Provider Demographics
NPI:1467597542
Name:OH, JUDY HYEYOUNG-JO (DDS)
Entity Type:Individual
Prefix:DR
First Name:JUDY
Middle Name:HYEYOUNG-JO
Last Name:OH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JUDY
Other - Middle Name:HYEYOUNG
Other - Last Name:JO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:5900 GROSVENOR LN
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-1850
Mailing Address - Country:US
Mailing Address - Phone:240-396-6119
Mailing Address - Fax:
Practice Address - Street 1:4607 CONNECTICUT AVE NW
Practice Address - Street 2:109
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-5751
Practice Address - Country:US
Practice Address - Phone:202-244-2212
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2009-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18845122300000X
MD14334122300000X
DC1000867122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist