Di Sun, DDS PHD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

11508 Issued in MD

Practice address

610 Professional Dr Ste 215
Gaithersburg, MD 20879-3439

Phone

(301) 869-8666

Fax

(301) 869-8677

NPI assigned

Sep 25, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 5

Addresses

Other identifiers 1

Other names 1

• Dr. Di Sun Professional name

Medicare fee-for-service enrollment

Enrolled in DC

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

Specialty

Oral Surgery

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Maryland Oral Diagnosis and Therapeutics, LLC

  • Dentist
  • Gaithersburg, MD
  • NPI 1760654784
  NPD Authorized official
• Diagnosti Pathology Services, Inc

  • Clinical Medical Laboratory
  • Clarksburg, MD
  • NPI 1609821248
  NPD (past)
• Frederick Health Hospital Inc

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1851491310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 PROFESSIONAL DR STE 215",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793439",
            "telephone_number": "301-869-8666",
            "fax_number": "301-869-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 PROFESSIONAL DR STE 215",
            "city": "GAITHERSBURG",
            "state": "MD",
            "postal_code": "208793439",
            "telephone_number": "301-869-8666",
            "fax_number": "301-869-8677"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "650 W Baltimore St",
            "address_purpose": "LOCATION",
            "city": "Baltimore",
            "state": "MD",
            "postal_code": "212011510",
            "country_code": "US",
            "telephone_number": "410-706-7060",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUN",
        "first_name": "DI",
        "name_prefix": "Dr.",
        "credential": "DDS PHD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MD",
            "license": "11508",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MD",
            "license": "11508",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "MD",
            "license": "11508",
            "primary": false
        },
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "DC",
            "license": "5326",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "DC",
            "license": "5326",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5486025",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DI",
            "last_name": "SUN",
            "prefix": "DR.",
            "credential": "DDS, PHD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Carole E Sullivan, CRNP
• Sultan Enterprise LLC
• Thomas P Sumser
• Sun Dental Associates PA
• Sun Dental Group
• Richard Sun, DDS
• Suncloud Health
• Sunflower Health & Wellness Consultants
• Bawi Thluai Sung, NP
• Sunrise Oral Surgery, LLC

• Oral and Maxillofacial Surgery (Dentist) in Gaithersburg, MD
• Providers in Gaithersburg, MD by specialty
• Oral and Maxillofacial Surgery (Dentist) in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.