Provider Demographics
NPI:1407372154
Name:SUN, HO HYUN BRIAN (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:HO HYUN
Middle Name:BRIAN
Last Name:SUN
Suffix:
Gender:M
Credentials:DMD, MS
Other - Prefix:DR
Other - First Name:HO-HYUN
Other - Middle Name:
Other - Last Name:SUN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DMD, MS
Mailing Address - Street 1:PO BOX 2062
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-0206
Mailing Address - Country:US
Mailing Address - Phone:408-692-6758
Mailing Address - Fax:408-317-1162
Practice Address - Street 1:225 N JACKSON AVE
Practice Address - Street 2:
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1603
Practice Address - Country:US
Practice Address - Phone:408-413-2043
Practice Address - Fax:408-413-0318
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-15
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS101577204E00000X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery