Provider Demographics
NPI:1114211653
Name:HO, WEI TING (DDS, MS)
Entity type:Individual
Prefix:
First Name:WEI TING
Middle Name:
Last Name:HO
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 E WASHINGTON ST
Mailing Address - Street 2:STE 2033
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60602-1708
Mailing Address - Country:US
Mailing Address - Phone:312-782-4068
Mailing Address - Fax:312-782-6509
Practice Address - Street 1:25 E WASHINGTON ST
Practice Address - Street 2:STE 2033
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60602-1708
Practice Address - Country:US
Practice Address - Phone:312-782-4068
Practice Address - Fax:312-782-6509
Is Sole Proprietor?:No
Enumeration Date:2011-06-01
Last Update Date:2014-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190285801223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics