Active NPI
Kevin Sun
- Dentist
- Denver, CO
National Provider Identifier
1215486139
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 107264
- Practice address
- 305 S Broadway
Ste 200-326
Denver, CO 80209 - Phone
- (817) 380-5574
- NPI assigned
- Oct 4, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 107264 | CA | Primary |
| Dentist | 122300000X | 32406 | TX | |
| General Practice Dentistry | 1223G0001X | 205864 | CO |
Addresses
Primary practice location
305 S Broadway
Ste 200-326
Denver, CO 80209
Mailing address
3204 N Main St Ste 120
Fort Worth, TX 76106-5900
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 |
|---|---|---|---|
| 32406 | TX | MD | Dentist |
| 205864 | CO | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1475539200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1788220800000",
"number": "1215486139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3204 N MAIN ST STE 120",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761065900"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "305 S BROADWAY",
"address_2": "STE 200-326",
"city": "DENVER",
"state": "CO",
"postal_code": "80209",
"telephone_number": "817-380-5574"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUN",
"first_name": "KEVIN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-10-04",
"last_updated": "2026-09-01",
"certification_date": "2026-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "107264",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "32406",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CO",
"license": "205864",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Denver, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.