Provider Demographics
NPI:1376704452
Name:WUN, EDMUND YING-PENG (DDS)
Entity type:Individual
Prefix:DR
First Name:EDMUND
Middle Name:YING-PENG
Last Name:WUN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 PALISADES DR STE 250
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12205-1448
Mailing Address - Country:US
Mailing Address - Phone:518-240-3750
Mailing Address - Fax:518-240-3759
Practice Address - Street 1:4 PALISADES DR STE 250
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-1448
Practice Address - Country:US
Practice Address - Phone:518-240-3750
Practice Address - Fax:518-240-3759
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0534011223S0112X
PADS0379641223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery