Healthcare Provider Details

I. General information

NPI: 1093609075
Provider Name (Legal Business Name): FANG SUN, DDS,PHD,PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3626 NE 45TH ST STE 200
SEATTLE WA
98105-5654
US

IV. Provider business mailing address

3626 NE 45TH ST STE 200
SEATTLE WA
98105-5654
US

V. Phone/Fax

Practice location:
  • Phone: 206-526-1437
  • Fax: 206-526-1437
Mailing address:
  • Phone: 206-526-1437
  • Fax: 206-526-1437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. FANG SUN
Title or Position: GENERAL DENTIST
Credential: DDS, PHD
Phone: 206-526-1437