Provider Demographics
NPI:1942978382
Name:SUNWOO, KYUNG (DMD)
Entity Type:Individual
Prefix:
First Name:KYUNG
Middle Name:
Last Name:SUNWOO
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21001 NW OLD PASS RD
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-8559
Mailing Address - Country:US
Mailing Address - Phone:323-684-7889
Mailing Address - Fax:
Practice Address - Street 1:310 SW 4TH AVE STE 100
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-2345
Practice Address - Country:US
Practice Address - Phone:503-489-4530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORD11521122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist