Provider Demographics
NPI:1770399370
Name:LITTLE SUNSHINE DENTAL GROUP
Entity type:Organization
Organization Name:LITTLE SUNSHINE DENTAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:CHUNG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:201-357-5812
Mailing Address - Street 1:315 CEDAR LN STE 2
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-3442
Mailing Address - Country:US
Mailing Address - Phone:201-357-5812
Mailing Address - Fax:201-357-5814
Practice Address - Street 1:315 CEDAR LN STE 2
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-3442
Practice Address - Country:US
Practice Address - Phone:201-357-5812
Practice Address - Fax:201-357-5814
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-09
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty