Ki-Sung Sung, D.D.S., M.S.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

54908 Issued in CA

Practice address

28237 Newhall Ranch Rd
Valencia, CA 91355-0986

Phone

(661) 257-4242

Fax

(661) 294-0020

NPI assigned

Feb 6, 2007

Last updated

Jul 8, 2007By 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 CA

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

Credentials

Master of Science

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.

• Cohen Sedgh, Manavi& Pakravan Dental Corporation

  dba Canyon Dental Group

  • Dentist
  • Valencia, CA
  • NPI 1083912430
  NPD (past)
• Joel Slaven DDS Inc

  dba Canyon Dental Group

  • General Practice Dentistry
  • Valencia, CA
  • NPI 1093939217
  NPD (past)

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1962541540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "960 CALLE DEL PACIFICO",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912083020",
            "telephone_number": "917-583-8543"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28237 NEWHALL RANCH RD",
            "city": "VALENCIA",
            "state": "CA",
            "postal_code": "913550986",
            "telephone_number": "661-257-4242",
            "fax_number": "661-294-0020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUNG",
        "first_name": "KI-SUNG",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "54908",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Suazo
• Gerald Subar, PHARM.D.
• Carol H Subrahmanyam, CCC,SLP
• Sum Tran MD Inc
• Jennifer Sung, M.D.
• Natalie Sung
• Nicholas Sunley
• Sunrise Senior Living Management, Inc. (Sunrise at Sterling Canyon)
• Supreme Healthcare, Inc (Bridges Home Health)
• Supreme Hospice Inc

• Periodontics in Valencia, CA
• Providers in Valencia, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.