Individual
JI SU OH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1801 ROBERT FULTON DR STE 100, RESTON, VA 20191-4347
(703) 495-3333
Mailing address
14565 LEE RD, CHANTILLY, VA 20151-1633
(703) 338-2275
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
0401419471
VA
Other
Enumeration date
05/30/2025
Last updated
06/16/2025
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