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General NPI Number Information
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NPI Number | 1417067554
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Entity Type | Organization
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Legal Business Name | H. ELAINE CHEONG, D.D.S., L.L.C.
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Dates
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Enumeration Date | 08/30/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 201 W BROADWAY BUILDING 2, SUITE A
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City | COLUMBIA
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State | MO
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Zip | 65203-3842
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Country | US
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Telephone | 573-499-0300
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Fax | 573-499-9088
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Provider Business Mailing Address
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Address Line | 201 W BROADWAY BUILDING 2, SUITE A
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City | COLUMBIA
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State | MO
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Zip | 65203-3842
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Country | US
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Telephone | 573-499-0300
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Fax | 573-499-9088
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Authorized Official
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Title or Position | DENTIST/OWNER
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Name | DR. HU Y. 'ELAINE' CHEONG
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Credential | D.D.S.
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Telephone | 573-499-0300
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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 | 2000143591
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License Number State | MO
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