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General NPI Number Information
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NPI Number | 1710831045
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Entity Type | Organization
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Legal Business Name | JONATHAN OH DDS PLLC
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Dates
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Enumeration Date | 02/24/2026
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Last Update Date | 02/24/2026
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Provider Practice Location Address
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Address Line | 3218 KENILWORTH AVE
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City | BERWYN
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State | IL
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Zip | 60402-3003
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Country | US
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Telephone | 708-797-9377
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Fax |
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Provider Business Mailing Address
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Address Line | 653 W BRIAR PL APT 3
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City | CHICAGO
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State | IL
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Zip | 60657-8406
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Country | US
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Telephone | 734-419-3099
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Fax |
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Authorized Official
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Title or Position | OWNER DENTIST
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Name | JONATHAN YOON OH
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Credential | DDS
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Telephone | 734-419-3099
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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