Provider Demographics
NPI:1376973180
Name:SUNG, HYUNSIK (DMD)
Entity Type:Individual
Prefix:DR
First Name:HYUNSIK
Middle Name:
Last Name:SUNG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 S CENTER ST
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75051-1815
Mailing Address - Country:US
Mailing Address - Phone:972-264-1662
Mailing Address - Fax:972-264-8677
Practice Address - Street 1:800 S CENTER ST
Practice Address - Street 2:
Practice Address - City:GRAND PRAIRIE
Practice Address - State:TX
Practice Address - Zip Code:75051-1815
Practice Address - Country:US
Practice Address - Phone:972-264-1662
Practice Address - Fax:972-264-6877
Is Sole Proprietor?:No
Enumeration Date:2013-11-14
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX294851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice