Healthcare Provider Details

I. General information

NPI: 1609709732
Provider Name (Legal Business Name): ANNETTE CHO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6160 ARLINGTON AVE STE D4
RIVERSIDE CA
92504-1900
US

IV. Provider business mailing address

314 CAJON ST APT D
REDLANDS CA
92373-5960
US

V. Phone/Fax

Practice location:
  • Phone: 951-637-0013
  • Fax:
Mailing address:
  • Phone: 541-961-5848
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number110948
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: