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General NPI Number Information
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NPI Number | 1194266213
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Entity Type | Individual
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Provider Name | ZHENGZHENG SUN DDS
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Gender | Male
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Dates
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Enumeration Date | 03/09/2017
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Last Update Date | 01/08/2024
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Provider Practice Location Address
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Address Line | 677 S 2ND AVE
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City | COVINA
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State | CA
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Zip | 91723-3518
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Country | US
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Telephone | 562-228-6330
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Fax |
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Provider Business Mailing Address
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Address Line | 1832 HUNTINGTON DR UNIT 13
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City | DUARTE
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State | CA
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Zip | 91010-2671
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Country | US
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Telephone | 562-228-6330
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 101986
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License Number State | CA
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