Provider Demographics
NPI:1497328843
Name:SOHN, JOON WOO (DMD)
Entity Type:Individual
Prefix:
First Name:JOON WOO
Middle Name:
Last Name:SOHN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4643
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91734-0643
Mailing Address - Country:US
Mailing Address - Phone:805-280-8818
Mailing Address - Fax:
Practice Address - Street 1:1825 CRYSTAL FALLS PKWY STE 130
Practice Address - Street 2:
Practice Address - City:LEANDER
Practice Address - State:TX
Practice Address - Zip Code:78641-4041
Practice Address - Country:US
Practice Address - Phone:737-777-3325
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-22
Last Update Date:2023-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX373951223G0001X
CA109551122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice