Healthcare Provider Details

I. General information

NPI: 1437569456
Provider Name (Legal Business Name): WENHUI SUN D.M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2014
Last Update Date: 01/16/2024
Certification Date: 01/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 ARCH ST STE 303
AKRON OH
44304-1432
US

IV. Provider business mailing address

2606 STEWART AVE STE 102
WAUSAU WI
54401-5450
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-6262
  • Fax:
Mailing address:
  • Phone: 715-842-5691
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number1001740-15
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: