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NPI Code Detail

MEDICARE: DR. MICHAEL Y CHON D.D.S.

MEDICARE: DR. MICHAEL Y CHON 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
11223G0001XGeneral Practice Dentistry59204CA
21223G0001XGeneral Practice Dentistry6251NV

General Provider Information

NPI Number : 1245558899
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL Y CHON D.D.S.
Provider Business Mailing Address
First Line : 7060 S DURANGO DR
Second Line : #110
City : LAS VEGAS
State : NV
Zip : 89113-2023
Country : US
Telephone Number : 702-722-6110
Fax Number :
Provider Business Practice Location Address
First Line : 7060 S DURANGO DR
Second Line : #110
City : LAS VEGAS
State : NV
Zip : 89113-2023
Country : US
Telephone Number : 702-722-6110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/06/2010
Last Update Date : 04/26/2016

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