Provider Demographics
NPI:1720468275
Name:KO, STEVEN SEUNGKYUN (DMD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:SEUNGKYUN
Last Name:KO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:74 BARNES CT APT 200
Mailing Address - Street 2:
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-7105
Mailing Address - Country:US
Mailing Address - Phone:484-347-3896
Mailing Address - Fax:
Practice Address - Street 1:877 W FREMONT AVE STE C3
Practice Address - Street 2:
Practice Address - City:SUNNYVALE
Practice Address - State:CA
Practice Address - Zip Code:94087-2319
Practice Address - Country:US
Practice Address - Phone:669-777-3215
Practice Address - Fax:669-777-3214
Is Sole Proprietor?:No
Enumeration Date:2015-05-30
Last Update Date:2019-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1014871223P0221X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry