Provider Demographics
NPI:1629161351
Name:SUNG, ERIC C (DDS)
Entity Type:Individual
Prefix:DR
First Name:ERIC
Middle Name:C
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:UCLA SCHOOL OF DENTISTRY. CHS A0-156
Mailing Address - Street 2:10833 LE CONTE AVE.
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-1668
Mailing Address - Country:US
Mailing Address - Phone:310-825-5889
Mailing Address - Fax:310-825-6345
Practice Address - Street 1:UCLA SCHOOL OF DENTISTRY. CHS A0-156
Practice Address - Street 2:10833 LE CONTE AVE.
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-1668
Practice Address - Country:US
Practice Address - Phone:310-825-5889
Practice Address - Fax:310-825-6345
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA383701223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice