Provider Demographics
NPI:1720104797
Name:SUN, LIYEN L (DDS)
Entity Type:Individual
Prefix:DR
First Name:LIYEN
Middle Name:L
Last Name:SUN
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 1:25835 NARBONNE AVE
Mailing Address - Street 2:STE. 265
Mailing Address - City:LOMITA
Mailing Address - State:CA
Mailing Address - Zip Code:90717-3074
Mailing Address - Country:US
Mailing Address - Phone:310-325-8600
Mailing Address - Fax:
Practice Address - Street 1:25835 NARBONNE AVE
Practice Address - Street 2:STE. 265
Practice Address - City:LOMITA
Practice Address - State:CA
Practice Address - Zip Code:90717-3074
Practice Address - Country:US
Practice Address - Phone:310-325-8600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28888122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist