Provider Demographics
NPI:1518344175
Name:SUK YOUNG AHN DDS INC
Entity Type:Organization
Organization Name:SUK YOUNG AHN DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MISS
Authorized Official - First Name:SUK
Authorized Official - Middle Name:YOUNG
Authorized Official - Last Name:AHN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:530-566-2598
Mailing Address - Street 1:111 RALEY BLVD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95928-8351
Mailing Address - Country:US
Mailing Address - Phone:530-342-0104
Mailing Address - Fax:530-342-8009
Practice Address - Street 1:111 RALEY BLVD
Practice Address - Street 2:SUITE 260
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95928-8351
Practice Address - Country:US
Practice Address - Phone:530-342-0104
Practice Address - Fax:530-342-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-04
Last Update Date:2015-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51226122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty