Provider Demographics
NPI:1508545708
Name:CHEON, HYOSANG (DDS)
Entity type:Individual
Prefix:MR
First Name:HYOSANG
Middle Name:
Last Name:CHEON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 MUNSON ST APT 470
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-0649
Mailing Address - Country:US
Mailing Address - Phone:718-710-2377
Mailing Address - Fax:
Practice Address - Street 1:310 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NORTH HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06473-1315
Practice Address - Country:US
Practice Address - Phone:860-609-3558
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-14
Last Update Date:2025-08-24
Deactivation Date:2024-05-16
Deactivation Code:
Reactivation Date:2025-08-21
Provider Licenses
StateLicense IDTaxonomies
CT14450122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist