Active NPI
Shan C Sun, D.D.S.
- General Practice Dentistry
- Lexington, KY
National Provider Identifier
1447322953
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 8806
- Practice address
- 496 Southland Dr
Lexington, KY 40503-1827 - Phone
- (859) 288-2425
- Fax
- (844) 670-2874
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 8806 | KY | Primary |
| Dentist | 122300000X | 8806 | KY |
Addresses
Primary practice location
496 Southland Dr
Lexington, KY 40503-1827
Mailing address
PO Box 39597
Belfast, ME 04915-1249
Phone (859) 288-2425
Other practice location 1
401 Highland Park Dr
Richmond, KY 40475-3839
Phone (859) 626-7700
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160412002549 | KY | Order and Referring Only - Dentist | 8527366277 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8806 | KY | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1789084800000",
"number": "1447322953",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 39597",
"city": "BELFAST",
"state": "ME",
"postal_code": "049151249",
"telephone_number": "859-288-2425",
"fax_number": "844-670-2874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "496 SOUTHLAND DR",
"city": "LEXINGTON",
"state": "KY",
"postal_code": "405031827",
"telephone_number": "859-288-2425",
"fax_number": "844-670-2874"
}
],
"practiceLocations": [
{
"address_1": "401 Highland Park Dr",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "KY",
"postal_code": "404753839",
"country_code": "US",
"telephone_number": "859-626-7700",
"fax_number": "859-626-7890",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SUN",
"first_name": "SHAN",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2026-09-11",
"certification_date": "2026-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "KY",
"license": "8806",
"primary": true
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "KY",
"license": "8806",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lexington, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2026; 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.