Provider Demographics
NPI:1952077794
Name:KOH, SEHIE OLIVIA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SEHIE
Middle Name:OLIVIA
Last Name:KOH
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 1:757 N CHESTNUT ST APT 401
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-3096
Mailing Address - Country:US
Mailing Address - Phone:313-559-3602
Mailing Address - Fax:
Practice Address - Street 1:5408 UNIVERSITY PKWY
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27105-1366
Practice Address - Country:US
Practice Address - Phone:313-559-3602
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-20
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC124601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice