Healthcare Provider Details

I. General information

NPI: 1093157729
Provider Name (Legal Business Name): CHI HYUN CHO D.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2013
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 W 31ST ST FL 2
NEW YORK NY
10001-4561
US

IV. Provider business mailing address

35 W 31ST ST FL 2
NEW YORK NY
10001-4561
US

V. Phone/Fax

Practice location:
  • Phone: 212-594-9197
  • Fax:
Mailing address:
  • Phone: 212-594-9197
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number058397
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: