SUN SURGICAL DENTAL GROUP NPI 1104697531

NPI Information

  • NPI: 1104697531
  • Provider Name: SUN SURGICAL DENTAL GROUP
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Organization
  • :
  • Address: 225 N JACKSON AVE
    SAN JOSE, CA
    ZIP 95116
  • Phone: (408) 259-5000

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NPI Details

SUN SURGICAL DENTAL GROUP is an oral and maxillofacial surgery dentist in San Jose, CA. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. SUN SURGICAL DENTAL GROUP NPI is 1104697531. The provider is registered as an organization entity type.
The provider .

The provider's business location address is:

225 N JACKSON AVE
SAN JOSE, CA
ZIP 95116-603
Phone: (408) 259-5000

The provider's authorized official is Ho Hyun Brian Sun .
The authorized official title is Chief Executive Officer and has the following contact phone number (408) 413-2043.

The enumeration date for this NPI number is 1/15/2024 and was last updated on 8/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1204E00000XOral & Maxillofacial SurgeryNo
2261QS0112XClinic/CenterOral and Maxillofacial SurgeryNo
31223S0112XDentistOral and Maxillofacial SurgeryYes

What is NPI?

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This page was last updated on: 11/21/2025

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