Provider Demographics
NPI:1023314259
Name:CHEONG, JUN (DDS)
Entity type:Individual
Prefix:
First Name:JUN
Middle Name:
Last Name:CHEONG
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 1:23000 CRENSHAW BLVD STE 207
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3052
Mailing Address - Country:US
Mailing Address - Phone:310-926-2234
Mailing Address - Fax:
Practice Address - Street 1:1007 W LA PALMA AVE
Practice Address - Street 2:STE 3
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-3620
Practice Address - Country:US
Practice Address - Phone:714-778-6160
Practice Address - Fax:714-778-2800
Is Sole Proprietor?:No
Enumeration Date:2011-02-05
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA523561223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice