Provider Demographics
NPI:1518686898
Name:OH, SO YEON (DDS)
Entity Type:Individual
Prefix:
First Name:SO YEON
Middle Name:
Last Name:OH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1547 HAWTHORNE ST
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15201-2045
Mailing Address - Country:US
Mailing Address - Phone:929-319-9079
Mailing Address - Fax:
Practice Address - Street 1:715 N HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-2563
Practice Address - Country:US
Practice Address - Phone:412-661-7316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-22
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0440721223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice