Provider Demographics
NPI:1629485818
Name:WON SUNG, DDS, LLC
Entity Type:Organization
Organization Name:WON SUNG, DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER/MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:WON
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:213-249-1765
Mailing Address - Street 1:431 SUMMIT ST
Mailing Address - Street 2:SUITE 104
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60120-3861
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2756 WHITEHALL LN
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60564-8490
Practice Address - Country:US
Practice Address - Phone:213-249-1765
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-19
Last Update Date:2014-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL248.0008981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty