Provider Demographics
NPI:1740451848
Name:CHO, LORI C (DMD)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:C
Last Name:CHO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:C
Other - Last Name:CHO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:150 N JACKSON AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95116-1908
Mailing Address - Country:US
Mailing Address - Phone:408-259-1004
Mailing Address - Fax:
Practice Address - Street 1:150 N JACKSON AVE STE 103
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1908
Practice Address - Country:US
Practice Address - Phone:408-259-1004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47462122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist