Healthcare Provider Details

I. General information

NPI: 1780100065
Provider Name (Legal Business Name): SARAH SUN YOUNG WANG DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: SUN YOUNG PARK DDS

II. Dates (important events)

Enumeration Date: 08/17/2017
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17991 EUCLID ST
FOUNTAIN VALLEY CA
92708-5409
US

IV. Provider business mailing address

5611 DRIFTWOOD AVE
LA PALMA CA
90623-1832
US

V. Phone/Fax

Practice location:
  • Phone: 714-378-0085
  • Fax:
Mailing address:
  • Phone: 310-429-4563
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDD4784
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: