# MARYLAND ORAL DIAGNOSIS AND THERAPEUTICS, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Maryland Oral Diagnosis and Therapeutics, LLC, Oral Pathology Services
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760654784
- **Authorized official:** DR. DI SUN DDS PHD (DIRECTOR)
- **Authorized official phone:** (301) 869-8666

## Contact information

- **Practice address:** 610 PROFESSIONAL DR STE 215, GAITHERSBURG, MD 20879-3439
- **Practice address phone:** (301) 869-8666
- **Practice address fax:** (301) 869-8677
- **Mailing address:** 610 PROFESSIONAL DR STE 215, GAITHERSBURG, MD 20879-3439
- **Mailing address phone:** (301) 838-9033
- **Mailing address fax:** (301) 838-9148

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 11508 | MD | Yes |
| 1223P0106X | Oral and Maxillofacial Pathology Dentistry | 11508 | MD | — |
| 1223P0106X | Oral and Maxillofacial Pathology Dentistry | 5326 | DC | — |

## Other

- **Enumeration date:** 03/31/2008
- **Last updated:** 07/15/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5486025 | — | MD |