Provider Demographics
NPI:1487333720
Name:CHATFIELD, HOSUNG RYU (DMD)
Entity type:Individual
Prefix:MR
First Name:HOSUNG
Middle Name:RYU
Last Name:CHATFIELD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:HOSUNG
Other - Middle Name:
Other - Last Name:RYU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7401 W WASHINGTON AVE APT 2104
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89128-4315
Mailing Address - Country:US
Mailing Address - Phone:702-738-4345
Mailing Address - Fax:
Practice Address - Street 1:640 E DEER SPRINGS WAY STE 180
Practice Address - Street 2:
Practice Address - City:NORTH LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89086-1514
Practice Address - Country:US
Practice Address - Phone:702-399-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV78731223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice