Provider Demographics
NPI:1891189452
Name:JEON, CHRISTOPHER HYOJAE (DDS)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:HYOJAE
Last Name:JEON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:HYO JAE
Other - Middle Name:CHRISTOPHER
Other - Last Name:JEON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1000 PROFESSIONAL DR
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94558-6410
Mailing Address - Country:US
Mailing Address - Phone:707-252-7733
Mailing Address - Fax:
Practice Address - Street 1:1000 PROFESSIONAL DR
Practice Address - Street 2:
Practice Address - City:NAPA
Practice Address - State:CA
Practice Address - Zip Code:94558-6410
Practice Address - Country:US
Practice Address - Phone:707-252-7733
Practice Address - Fax:707-252-4369
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-22
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64330122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist