| Sung Ahn Dds, Inc. | |
|
1490 E Foothill Blvd Ste B Upland CA 91786-4072 | |
| (909) 256-4457 | |
| Not Available |
| Full Name | Sung Ahn Dds, Inc. |
|---|---|
| Speciality | Clinic/Center |
| Location | 1490 E Foothill Blvd Ste B, Upland, California |
| Authorized Official Name and Position | Sung Min Ahn (CEO) |
| Authorized Official Contact | 9092564457 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sung Ahn Dds, Inc. 1490 E Foothill Blvd Ste B Upland CA 91786-4072 Ph: (909) 256-4457 | Sung Ahn Dds, Inc. 1490 E Foothill Blvd Ste B Upland CA 91786-4072 Ph: (909) 256-4457 |
| NPI Number | 1649817404 |
|---|---|
| Provider Enumeration Date | 11/28/2019 |
| Last Update Date | 07/06/2021 |
| Medicare PECOS PAC ID | 9335541119 |
|---|---|
| Medicare Enrollment ID | O20210715004160 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649817404 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Secondary |
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
| Provider Name | Sung Min Ahn |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1326067489 PECOS PAC ID: 1052710738 Enrollment ID: I20210531000022 |
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