MEDICARE: WEON CHEOL JOO D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	53461	CA

General Provider Information

NPI Number	:	1194892547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WEON CHEOL JOO D.D.S.

Provider Business Mailing Address
First Line	:	1702 S HOOVER ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-4962
Country	:	US
Telephone Number	:	213-383-8275
Fax Number	:	213-205-8415

Provider Business Practice Location Address
First Line	:	1702 S HOOVER ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90006-4962
Country	:	US
Telephone Number	:	213-383-8275
Fax Number	:	213-205-8415

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/29/2006
Last Update Date	:	04/21/2026

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Directions to “ WEON CHEOL JOO D.D.S.” Practice Location

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