MEDICARE: DR. SHIHPEN SUN D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	29491	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134138381
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHIHPEN SUN D.D.S.

Provider Business Mailing Address
First Line	:	13861 BEACH BLVD
Second Line	:	SUITE #4
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-4002
Country	:	US
Telephone Number	:	714-897-4471
Fax Number	:	714-892-9898

Provider Business Practice Location Address
First Line	:	13861 BEACH BLVD
Second Line	:	SUITE #4
City	:	WESTMINSTER
State	:	CA
Zip	:	92683-4002
Country	:	US
Telephone Number	:	714-897-4471
Fax Number	:	714-892-9898

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	07/09/2007

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