MEDICARE: DR. JOANNA LIN-YAO SUN DDS

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
1	1223G0001X	General Practice Dentistry	DE 60108662	WA

General Provider Information

NPI Number	:	1285968891
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOANNA LIN-YAO SUN DDS

Provider Business Mailing Address
First Line	:	2150 112TH AVE NE
Second Line	:	SUITE B
City	:	BELLEVUE
State	:	WA
Zip	:	98004-2975
Country	:	US
Telephone Number	:	425-454-2892
Fax Number	:

Provider Business Practice Location Address
First Line	:	2150 112TH AVE NE
Second Line	:	SUITE B
City	:	BELLEVUE
State	:	WA
Zip	:	98004-2975
Country	:	US
Telephone Number	:	425-454-2892
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2009
Last Update Date	:	09/29/2009

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