Provider Demographics
NPI:1285968891
Name:SUN, JOANNA LIN-YAO (DDS)
Entity type:Individual
Prefix:DR
First Name:JOANNA
Middle Name:LIN-YAO
Last Name:SUN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2150 112TH AVE NE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-2975
Mailing Address - Country:US
Mailing Address - Phone:425-454-2892
Mailing Address - Fax:
Practice Address - Street 1:2150 112TH AVE NE
Practice Address - Street 2:SUITE B
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-2975
Practice Address - Country:US
Practice Address - Phone:425-454-2892
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-29
Last Update Date:2009-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 601086621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice