Isaac Sun, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

100603 Issued in CA

Practice address

11180 Warner Ave Ste 251
Fountain Valley, CA 92708-7515

Phone

(833) 598-3368

NPI assigned

Aug 30, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Isaac J Sun DDS Inc

  • Dental Clinic/Center
  • Fountain Valley, CA
  • NPI 1801777859
  NPD Authorized official
• Sun Jiaqi DDS, Inc.

  • Dental Clinic/Center
  • Tustin, CA
  • NPI 1083209175
  NPD Authorized official
• Lynda Watanabe Professional Dental Corporation

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Riverside, CA
  • NPI 1598864738
  NPD (past)

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

{
    "created_epoch": "1472515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683763200000",
    "number": "1417403395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE STE 251",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11180 WARNER AVE STE 251",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087515",
            "telephone_number": "833-598-3368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUN",
        "first_name": "ISAAC",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-30",
        "last_updated": "2023-05-11",
        "certification_date": "2023-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "100603",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brian Christopher Stuckman, RN
• Paul Zachary Stumpe, PHARMD
• Derrick Weison Su, MD
• Angeli D Suarez, M.D.
• Shunmugaraja Subbiah, M.D.
• Ettayapurum V Sunderrajan, M.D.
• Sobha Sunderrajan, M.D.
• Sarah Sung, PHARMD
• Sunita Moola MD Inc
• Sunrise Home Health Care LLC

• Dentist in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.