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NPI 1093609075

NPI 1093609075 : FANG SUN, DDS,PHD,PLLC : SEATTLE, WA

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General NPI Number Information
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    NPI Number           |    1093609075
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    Entity Type          |    Organization 
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    Legal Business Name  |    FANG SUN, DDS,PHD,PLLC 
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Dates
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    Enumeration Date     |    06/05/2025
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    Last Update Date     |    06/05/2025
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Provider Practice Location Address
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    Address Line         |    3626 NE 45TH ST STE 200 
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    City                 |    SEATTLE
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    State                |    WA
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    Zip                  |    98105-5654
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    Country              |    US
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    Telephone            |    206-526-1437
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    Fax                  |    206-526-1437
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Provider Business Mailing Address
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    Address Line         |    3626 NE 45TH ST STE 200 
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    City                 |    SEATTLE
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    State                |    WA
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    Zip                  |    98105-5654
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    Country              |    US
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    Telephone            |    206-526-1437
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    Fax                  |    206-526-1437
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Authorized Official
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    Title or Position    |    GENERAL DENTIST
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    Name                 |    DR. FANG  SUN 
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    Credential           |    DDS, PHD
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    Telephone            |    206-526-1437
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    1223G0001X
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    Taxonomy Name        |    General Practice Dentistry
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    License Number       |    
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    License Number State |    
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Taxonomy #2
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    Taxonomy Code        |    122300000X
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    Taxonomy Name        |    Dentist
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    License Number       |    
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    License Number State |    
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