Provider Demographics
NPI:1154517423
Name:SUN, SHAN-LEI (DDS)
Entity type:Individual
Prefix:DR
First Name:SHAN-LEI
Middle Name:
Last Name:SUN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:SHANLEI
Other - Middle Name:
Other - Last Name:SUN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:1250 GERMANO WAY
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:CA
Mailing Address - Zip Code:94566-2243
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1250 GERMANO WAY
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:CA
Practice Address - Zip Code:94566-2243
Practice Address - Country:US
Practice Address - Phone:310-948-2158
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2007-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA56180122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist