Victor Sun, DMD
Individual provider Active NPI General Practice Dentistry · JB MDL, NJ
NPI 1679064547 · NPPES record last updated Jun 20, 2023
Key facts
- NPI
- 1679064547
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- 10960883-9922 (UT)
- Practice address
- 3458 Neely Rd
JB MDL, NJ 08641-5312 - Phone
- (949) 436-7868
- NPI assigned
- May 25, 2018
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10960883-9922 | UT | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 10960883-9922 | UT | Yes |
Addresses
Primary practice location
3458 Neely Rd
JB MDL, NJ 08641-5312
Mailing address
14 Park PL
Princeton, NJ 08542-6919
Other providers in JB MDL, NJ
- John Robert Smith
- Elaine Jamina Steele
- Heather Ann Steelman
- Patrick Andrew Stockton
- Tanner Strommen
- Dina F Tangan
- Mackenzie Lynn Werfel
- Melanie Wilson
- Chen Yang
- Wenguang You
All providers in JB MDL, NJ · General Practice Dentistry in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.