Provider Demographics
NPI:1427255090
Name:KOH, HEE YON (DMD)
Entity type:Individual
Prefix:
First Name:HEE YON
Middle Name:
Last Name:KOH
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 THORNHURST
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-2181
Mailing Address - Country:US
Mailing Address - Phone:862-571-2518
Mailing Address - Fax:
Practice Address - Street 1:25100 MARGUERITE PKWY STE A
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92692-2467
Practice Address - Country:US
Practice Address - Phone:949-768-3801
Practice Address - Fax:949-768-7701
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-28
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60415122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist