Provider Demographics
NPI:1235790866
Name:SUNG, STEPHEN Y (DDS)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:Y
Last Name:SUNG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3450 S STATE HIGHWAY 161 STE 200
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-7281
Mailing Address - Country:US
Mailing Address - Phone:972-820-7214
Mailing Address - Fax:
Practice Address - Street 1:721 S INTERSTATE 35 E STE 206
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76205-8153
Practice Address - Country:US
Practice Address - Phone:940-380-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-25
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX35316122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist