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General NPI Number Information
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NPI Number | 1548479710
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Entity Type | Individual
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Provider Name | JILLWEN SUNG D.M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 11/14/2010
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Provider Practice Location Address
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Address Line | 6918 CORPORATE DR SUITE A-11
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City | HOUSTON
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State | TX
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Zip | 77036-5112
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Country | US
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Telephone | 713-271-7878
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Fax |
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Provider Business Mailing Address
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Address Line | 6918 CORPORATE DR SUITE A-11
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City | HOUSTON
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State | TX
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Zip | 77036-5112
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Country | US
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Telephone | 713-271-7878
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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 | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 050526
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | 22073
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License Number State | TX
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