Provider Demographics
NPI:1932322260
Name:CHON, PAUL PAEK (DDS)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:PAEK
Last Name:CHON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3620 S BRISTOL ST STE 206
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92704-7315
Mailing Address - Country:US
Mailing Address - Phone:714-545-0453
Mailing Address - Fax:714-545-4553
Practice Address - Street 1:3620 S BRISTOL ST
Practice Address - Street 2:SUITE 206
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92704-7300
Practice Address - Country:US
Practice Address - Phone:714-545-0453
Practice Address - Fax:714-545-4553
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45442122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist