Provider Demographics
NPI:1053522185
Name:OH, SUJEAN (DDS)
Entity type:Individual
Prefix:DR
First Name:SUJEAN
Middle Name:
Last Name:OH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 FAWNHILL RD
Mailing Address - Street 2:
Mailing Address - City:UPPER SADDLE RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07458-1517
Mailing Address - Country:US
Mailing Address - Phone:201-934-8216
Mailing Address - Fax:
Practice Address - Street 1:31 SHERIDAN AVE
Practice Address - Street 2:
Practice Address - City:HO HO KUS
Practice Address - State:NJ
Practice Address - Zip Code:07423-1572
Practice Address - Country:US
Practice Address - Phone:201-251-8131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI205221223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics