National Provider Identifier
Kyoungsoo Jeon
Kyoungsoo Jeon is listed in the NPPES registry with a primary specialty of Dentist in Dunkirk, NY and a listed phone number of (716) 366-6822.
Profile Overview
- NPI
- 1245728104
- Provider Type
- Individual
- Primary Specialty
- Dentist
- Enumeration Date
- April 26, 2018
- Last Updated
- October 15, 2024
Practice Location
- 10765 Bennett RD
- Dunkirk, NY 14048-3567
Phone: (716) 366-6822
Specialties
- Dentist (122300000X)
- Dentist (122300000X)
- Student in an Organized Health Care Education/Training Program (390200000X)
Full Record
- NPI
- 1245728104
- Entity Type
- Individual
- Last Name
- Jeon
- First Name
- Kyoungsoo
- Mailing Street Address
- 10765 Bennett RD
- Mailing City
- Dunkirk
- Mailing State
- NY
- Mailing ZIP Code
- 14048-3567
- Mailing Country
- US
- Mailing Phone
- (716) 366-6822
- Practice Street Address
- 10765 Bennett RD
- Practice City
- Dunkirk
- Practice State
- NY
- Practice ZIP Code
- 14048-3567
- Practice Country
- US
- Practice Phone
- (716) 366-6822
- Enumeration Date
- April 26, 2018
- Last Updated
- October 15, 2024
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- October 15, 2024
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Dentist (122300000X), Dentist (122300000X), Student in an Organized Health Care Education/Training Program (390200000X)