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General NPI Number Information
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NPI Number | 1023314259
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Entity Type | Individual
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Provider Name | JUN CHEONG DDS
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Gender | Male
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Dates
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Enumeration Date | 02/05/2011
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Last Update Date | 11/19/2018
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Provider Practice Location Address
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Address Line | 1007 W LA PALMA AVE STE 3
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City | ANAHEIM
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State | CA
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Zip | 92801-3620
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Country | US
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Telephone | 714-778-6160
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Fax | 714-778-2800
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Provider Business Mailing Address
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Address Line | 23000 CRENSHAW BLVD STE 207
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City | TORRANCE
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State | CA
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Zip | 90505-3052
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Country | US
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Telephone | 310-926-2234
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 52356
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License Number State | CA
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