MEDICARE: I. W. HO, D.D.S., INC.

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	1223G0001X	General Practice Dentistry	53146	CA
2	1223G0001X	General Practice Dentistry	39010	CA

General Provider Information

NPI Number	:	1710971197
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	I. W. HO, D.D.S., INC.

Provider Business Mailing Address
First Line	:	29829 SANTA MARGARITA PKWY
Second Line	:	SUITE 500
City	:	RANCHO SANTA MARGARITA
State	:	CA
Zip	:	92688-3622
Country	:	US
Telephone Number	:	949-888-0806
Fax Number	:	949-888-0199

Provider Business Practice Location Address
First Line	:	29829 SANTA MARGARITA PKWY
Second Line	:	SUITE 500
City	:	RANCHO SANTA MARGARITA
State	:	CA
Zip	:	92688-3622
Country	:	US
Telephone Number	:	949-888-0806
Fax Number	:	949-888-0199

Authorized Official
Title or Position	:	OWNER
Name	:	DR. IVAN W. HO
Credential	:	D.D.S.
Telephone Number	:	949-888-0806

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	02/19/2009

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Directions to “I. W. HO, D.D.S., INC. ” Practice Location

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