Provider Demographics
NPI:1790123735
Name:FUNG, KINSUN DAVID (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:KINSUN
Middle Name:DAVID
Last Name:FUNG
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10605 JAMAICA AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HILL
Mailing Address - State:NY
Mailing Address - Zip Code:11418-2016
Mailing Address - Country:US
Mailing Address - Phone:718-441-4411
Mailing Address - Fax:718-441-4412
Practice Address - Street 1:10605 JAMAICA AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND HILL
Practice Address - State:NY
Practice Address - Zip Code:11418-2016
Practice Address - Country:US
Practice Address - Phone:718-441-4411
Practice Address - Fax:718-441-4412
Is Sole Proprietor?:No
Enumeration Date:2013-06-12
Last Update Date:2022-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY057332122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist