Provider Demographics
NPI:1770626962
Name:OH, MICHAEL CHEUNG (DMD)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:CHEUNG
Last Name:OH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15962 ESQUILIME DR
Mailing Address - Street 2:
Mailing Address - City:CHINO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91709-2259
Mailing Address - Country:US
Mailing Address - Phone:714-572-0124
Mailing Address - Fax:
Practice Address - Street 1:15962 ESQUILIME DR
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-2259
Practice Address - Country:US
Practice Address - Phone:714-572-0124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA479781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice