Ningyuan Sun

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DEN4997 Issued in ME

Practice address

1 College St
Portland, ME 04103-2617

Phone

(207) 221-4747

NPI assigned

May 29, 2019

Last updated

Dec 16, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 MA

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

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

• Penobscot Community Health Center

  dba Penobscot Community Dental Clinic

  • Dentist
  • Bangor, ME
  • NPI 1053404996
  NPD (past)

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765843200000",
    "number": "1851959563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "716 STEVENS AVE OFC 308",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032666",
            "telephone_number": "617-690-9572"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 COLLEGE ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041032617",
            "telephone_number": "207-221-4747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1048 Union St",
            "address_purpose": "LOCATION",
            "city": "Bangor",
            "state": "ME",
            "postal_code": "044013016",
            "country_code": "US",
            "telephone_number": "207-992-2152",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "650 Brighton Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "ME",
            "postal_code": "041021035",
            "country_code": "US",
            "telephone_number": "207-614-7487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUN",
        "first_name": "NINGYUAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-05-29",
        "last_updated": "2025-12-16",
        "certification_date": "2025-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "ME",
            "license": "DEN4997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maura Corcoran Sullivan, PSY.D.
• Michael P Sullivan, MD
• William M Sullivan, M.D.
• Jennie S Summers-Shea, LCPC
• Sun Valley Plus LLC
• Michael Sundberg, D.D.S.
• Kaiya Mare' Sundeen
• Karen Joan Sundqvist, M.A., CCC-SLP
• Mary Beth H Sunenblick, LCSW
• Sunrise Home Care of Maine LLC

• Periodontics in Portland, ME
• Providers in Portland, ME by specialty
• Periodontics in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2025; 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.