Provider Demographics
NPI:1841339769
Name:SUNWOO, MAN (DMD)
Entity type:Individual
Prefix:
First Name:MAN
Middle Name:
Last Name:SUNWOO
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14700 NE 8TH ST
Mailing Address - Street 2:SUITE 210
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007
Mailing Address - Country:US
Mailing Address - Phone:425-378-1600
Mailing Address - Fax:425-643-0971
Practice Address - Street 1:14700 NE 8TH ST
Practice Address - Street 2:SUITE 210
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007
Practice Address - Country:US
Practice Address - Phone:425-378-1600
Practice Address - Fax:425-643-0971
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE94841223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice