Provider Demographics
NPI:1861140105
Name:SOH, NAYONGE (DDS)
Entity type:Individual
Prefix:DR
First Name:NAYONGE
Middle Name:
Last Name:SOH
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 1:2329 IROQUOIS DR
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-1033
Mailing Address - Country:US
Mailing Address - Phone:773-742-1410
Mailing Address - Fax:
Practice Address - Street 1:195 N ARLINGTON HEIGHTS RD STE 150
Practice Address - Street 2:
Practice Address - City:BUFFALO GROVE
Practice Address - State:IL
Practice Address - Zip Code:60089-1768
Practice Address - Country:US
Practice Address - Phone:847-537-7695
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-15
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190248891223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry