Provider Demographics
NPI:1285406413
Name:SUNBURST DENTAL P.C
Entity type:Organization
Organization Name:SUNBURST DENTAL P.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HENG
Authorized Official - Middle Name:
Authorized Official - Last Name:XU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:630-296-9297
Mailing Address - Street 1:1504 N NAPER BLVD STE 152
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-4819
Mailing Address - Country:US
Mailing Address - Phone:630-296-9297
Mailing Address - Fax:630-296-9139
Practice Address - Street 1:1504 N NAPER BLVD STE 152
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-4819
Practice Address - Country:US
Practice Address - Phone:630-296-9297
Practice Address - Fax:630-296-9139
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental