Provider Demographics
NPI:1295097764
Name:SUNNY DENTAL PLLC
Entity type:Organization
Organization Name:SUNNY DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:KUAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-324-4152
Mailing Address - Street 1:2327 WORTHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75204-2649
Mailing Address - Country:US
Mailing Address - Phone:925-324-4152
Mailing Address - Fax:
Practice Address - Street 1:2327 WORTHINGTON ST
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-2649
Practice Address - Country:US
Practice Address - Phone:925-324-4152
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-11
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX25870261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental