Provider Demographics
NPI:1043441579
Name:SUN, DOOGI (DDS)
Entity Type:Individual
Prefix:DR
First Name:DOOGI
Middle Name:
Last Name:SUN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:DOOGIE
Other - Middle Name:
Other - Last Name:SUN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:8006 15TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-3601
Mailing Address - Country:US
Mailing Address - Phone:206-789-6377
Mailing Address - Fax:206-781-9291
Practice Address - Street 1:8006 15TH AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-3601
Practice Address - Country:US
Practice Address - Phone:206-789-6377
Practice Address - Fax:206-781-9291
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-31
Last Update Date:2022-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI024173001223G0001X
TX262741223G0001X
WA610357951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice