Provider Demographics
NPI:1780454199
Name:SEUNG C SON DDS, INC
Entity type:Organization
Organization Name:SEUNG C SON DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:SEUNG
Authorized Official - Middle Name:CHEON
Authorized Official - Last Name:SON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:562-665-0738
Mailing Address - Street 1:1144 S WESTERN AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90006-2376
Mailing Address - Country:US
Mailing Address - Phone:714-870-4111
Mailing Address - Fax:
Practice Address - Street 1:1144 S WESTERN AVE STE 210
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90006-2376
Practice Address - Country:US
Practice Address - Phone:714-870-4111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SEUNG C SON DDS, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty