Healthcare Provider Details

I. General information

NPI: 1407372154
Provider Name (Legal Business Name): HO HYUN BRIAN SUN DMD, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HO-HYUN SUN DMD, MS

II. Dates (important events)

Enumeration Date: 08/15/2017
Last Update Date: 08/11/2025
Certification Date: 08/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 N JACKSON AVE
SAN JOSE CA
95116-1603
US

IV. Provider business mailing address

PO BOX 2062
DUBLIN CA
94568-0206
US

V. Phone/Fax

Practice location:
  • Phone: 408-259-5000
  • Fax:
Mailing address:
  • Phone: 408-692-6758
  • Fax: 408-317-1162

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License NumberDDS101577
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDDS101577
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: