Provider Demographics
NPI:1831238567
Name:KO, GEORGE MING HUI (DDS)
Entity type:Individual
Prefix:DR
First Name:GEORGE MING HUI
Middle Name:
Last Name:KO
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:MING
Other - Middle Name:
Other - Last Name:KO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1214 S SAN GABRIEL BLVD
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3117
Mailing Address - Country:US
Mailing Address - Phone:626-284-8022
Mailing Address - Fax:877-283-4284
Practice Address - Street 1:1214 S SAN GABRIEL BLVD
Practice Address - Street 2:
Practice Address - City:SAN GABRIEL
Practice Address - State:CA
Practice Address - Zip Code:91776-3117
Practice Address - Country:US
Practice Address - Phone:626-284-8022
Practice Address - Fax:877-283-4284
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA380711223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAB38071-01Medicare ID - Type UnspecifiedDENTI-CAL ID NUMBER