Healthcare Provider Details

I. General information

NPI: 1538081443
Provider Name (Legal Business Name): JENNIFER SUN DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39141 CIVIC CENTER DR STE 220
FREMONT CA
94538-5823
US

IV. Provider business mailing address

1569 LOCUST ST
LIVERMORE CA
94551-2038
US

V. Phone/Fax

Practice location:
  • Phone: 510-505-8707
  • Fax:
Mailing address:
  • Phone: 916-529-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. JENNIFER SUN
Title or Position: PRESIDENT
Credential: DDS
Phone: 916-529-9000