Provider Demographics
NPI:1841632791
Name:SUNG, CASPAR LAKHO (DDS)
Entity type:Individual
Prefix:DR
First Name:CASPAR
Middle Name:LAKHO
Last Name:SUNG
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 1:414 W PACIFIC COAST HWY
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:CA
Mailing Address - Zip Code:90744-2524
Mailing Address - Country:US
Mailing Address - Phone:310-518-3522
Mailing Address - Fax:
Practice Address - Street 1:414 W PACIFIC COAST HWY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:CA
Practice Address - Zip Code:90744-2524
Practice Address - Country:US
Practice Address - Phone:310-518-3522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-20
Last Update Date:2013-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA288211223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice