Provider Demographics
NPI:1659197770
Name:JOO, DIANA H (DDS)
Entity type:Individual
Prefix:
First Name:DIANA
Middle Name:H
Last Name:JOO
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:HEE
Other - Middle Name:RYANG
Other - Last Name:JOO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:112 HARVARD DR
Mailing Address - Street 2:
Mailing Address - City:TRAPPE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-1941
Mailing Address - Country:US
Mailing Address - Phone:703-309-7116
Mailing Address - Fax:
Practice Address - Street 1:112 HARVARD DR
Practice Address - Street 2:
Practice Address - City:TRAPPE
Practice Address - State:PA
Practice Address - Zip Code:19426-1941
Practice Address - Country:US
Practice Address - Phone:703-309-7116
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program