Provider Demographics
NPI:1457435661
Name:SUNGA, ELAINE V (DDS)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:V
Last Name:SUNGA
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 1:860 KUHN DR
Mailing Address - Street 2:#201
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91914
Mailing Address - Country:US
Mailing Address - Phone:619-591-5950
Mailing Address - Fax:619-591-5980
Practice Address - Street 1:860 KUHN DR
Practice Address - Street 2:#201
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91914
Practice Address - Country:US
Practice Address - Phone:619-591-5950
Practice Address - Fax:619-591-5980
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51378122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist