Provider Demographics
NPI:1639275225
Name:WU, KAILING SUNG (DDS)
Entity Type:Individual
Prefix:
First Name:KAILING
Middle Name:SUNG
Last Name:WU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:455 CENTRAL PARK AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-1034
Mailing Address - Country:US
Mailing Address - Phone:914-472-1884
Mailing Address - Fax:
Practice Address - Street 1:455 CENTRAL PARK AVE STE 310
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-1034
Practice Address - Country:US
Practice Address - Phone:914-472-1884
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2015-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051406-11223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice