Provider Demographics
NPI:1710316690
Name:CHO, JAI
Entity type:Individual
Prefix:
First Name:JAI
Middle Name:
Last Name:CHO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:442 SANTA LOUISA
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-0802
Mailing Address - Country:US
Mailing Address - Phone:909-963-8221
Mailing Address - Fax:
Practice Address - Street 1:1401 AVOCADO AVE STE 603
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-8715
Practice Address - Country:US
Practice Address - Phone:909-963-8221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2025-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1114201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice