Individual provider Active NPI

Benjamin Pingtzee Sun, D.D.S.

  • General Practice Dentistry
  • Westlake Village, CA
National Provider Identifier
1225189475
Registry record updated Jan 29, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
53952 Issued in CA
Practice address
32144 Agoura Rd
Suite 204
Westlake Village, CA 91361-4031
Phone
(818) 597-9777
Fax
(818) 597-9595
NPI assigned
Jan 15, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 29, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 53952 CA Primary

Addresses

Primary practice location

32144 Agoura Rd
Suite 204
Westlake Village, CA 91361-4031

Mailing address

32144 Agoura Rd
Suite 204
Westlake Village, CA 91361-4031
Phone (818) 597-9777

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.
Opted out of Medicare
Yes, effective Jun 9, 2016 through Jun 9, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
53952CAMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1168819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1359417600000",
    "number": "1225189475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "32144 AGOURA RD",
            "address_2": "SUITE 204",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913614031",
            "telephone_number": "818-597-9777",
            "fax_number": "818-597-9595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "32144 AGOURA RD",
            "address_2": "SUITE 204",
            "city": "WESTLAKE VILLAGE",
            "state": "CA",
            "postal_code": "913614031",
            "telephone_number": "818-597-9777",
            "fax_number": "818-597-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUN",
        "first_name": "BENJAMIN",
        "middle_name": "PINGTZEE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-15",
        "last_updated": "2013-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "53952",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Westlake Village, CA

Sources for this page

Verify at the official NPI Registry.