MEDICARE: ROCKAWAY DENTAL CENTER LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1477345718
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROCKAWAY DENTAL CENTER LLC

Provider Business Mailing Address
First Line	:	343 MOUNT HOPE AVE
Second Line	:	SUITE 8
City	:	ROCKAWAY
State	:	NJ
Zip	:	07866-1646
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	343 MOUNT HOPE AVE
Second Line	:	SUITE 8
City	:	ROCKAWAY
State	:	NJ
Zip	:	07866-1646
Country	:	US
Telephone Number	:	630-923-2666
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. SUNG HOON CHO
Credential	:	DMD
Telephone Number	:	630-923-2666

Provider Enumeration Date	:	05/21/2025
Last Update Date	:	05/21/2025

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