Provider Demographics
NPI:1083868525
Name:DENTAL SUNSHINE
Entity Type:Organization
Organization Name:DENTAL SUNSHINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HYUN
Authorized Official - Middle Name:SUN
Authorized Official - Last Name:CHUN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-633-0400
Mailing Address - Street 1:1803 S THROOP STREET
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60608
Mailing Address - Country:US
Mailing Address - Phone:312-633-0400
Mailing Address - Fax:
Practice Address - Street 1:233 E 13TH ST
Practice Address - Street 2:1309
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60605
Practice Address - Country:US
Practice Address - Phone:312-633-0400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019026407122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty