Active NPI
Tina Sun, DDS
- Periodontics
- City of Industry, CA
National Provider Identifier
1144423278
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 51138
- Practice address
- 18645 Gale Ave Ste 180
City of Industry, CA 91748-1370 - Phone
- (626) 641-1388
- NPI assigned
- Jun 6, 2007
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 51138 | CA | Primary |
Addresses
Primary practice location
18645 Gale Ave Ste 180
City of Industry, CA 91748-1370
Mailing address
877 W El Repetto Dr Apt 50a
Monterey Park, CA 91754-5245
Phone (626) 676-2588
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 51138 | CA | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1181088000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1144423278",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "877 W EL REPETTO DR APT 50A",
"city": "MONTEREY PARK",
"state": "CA",
"postal_code": "917545245",
"telephone_number": "626-676-2588"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "18645 GALE AVE STE 180",
"city": "CITY OF INDUSTRY",
"state": "CA",
"postal_code": "917481370",
"telephone_number": "626-641-1388"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUN",
"first_name": "TINA",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-06-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "CA",
"license": "51138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in City of Industry, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.