Individual provider Active NPI

Sarah Sun Young Wang, DDS

  • General Practice Dentistry
  • Fountain Valley, CA
National Provider Identifier
1780100065
Registry record updated Jul 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DD4784 Issued in NM
Practice address
17991 Euclid St
Fountain Valley, CA 92708-5409
Phone
(714) 378-0085
NPI assigned
Aug 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2026

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 DD4784 NM Primary

Addresses

Primary practice location

17991 Euclid St
Fountain Valley, CA 92708-5409

Mailing address

5611 Driftwood Ave
La Palma, CA 90623-1832
Phone (310) 429-4563

Other names 1

  • Sun Young Park Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NM
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

Enrollment IDStateProvider typePAC IDDetails
I20170907002582 NM Order and Referring Only - DentistPractitioner - Dentist 4587937834

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Krystal Pham DDS, Inc Past Accepting new patients
Familia Dental Esp LLC General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1502928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784764800000",
    "number": "1780100065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5611 DRIFTWOOD AVE",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231832",
            "telephone_number": "310-429-4563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17991 EUCLID ST",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927085409",
            "telephone_number": "714-378-0085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WANG",
        "first_name": "SARAH",
        "middle_name": "SUN YOUNG",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-17",
        "last_updated": "2026-07-23",
        "certification_date": "2026-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NM",
            "license": "DD4784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUN YOUNG",
            "last_name": "PARK",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fountain Valley, CA

Sources for this page

Verify at the official NPI Registry.