MEDICARE: SUNYONG J WON DDS INC

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	44125	CA

General Provider Information

NPI Number	:	1851533079
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SUNYONG J WON DDS INC

Provider Business Mailing Address
First Line	:	1790 E AVENUE J
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93535-4474
Country	:	US
Telephone Number	:	661-948-8187
Fax Number	:	661-948-1134

Provider Business Practice Location Address
First Line	:	1790 E AVENUE J
Second Line	:
City	:	LANCASTER
State	:	CA
Zip	:	93535-4474
Country	:	US
Telephone Number	:	661-948-8187
Fax Number	:	661-948-1134

Authorized Official
Title or Position	:	CEO
Name	:	DR. JONATHAN S WON
Credential	:	DDS
Telephone Number	:	661-948-8187

Provider Enumeration Date	:	04/02/2009
Last Update Date	:	04/02/2009

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