# EDWARD IM DDS PS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Sunrise Dental Specialist
- **Organization subpart:** No

## Provider details

- **NPI number:** 1962933150
- **Authorized official:** SARAH IM (OFFICE MANAGER)
- **Authorized official phone:** (425) 450-9500

## Contact information

- **Practice address:** 1200 112TH AVE NE, C222, BELLEVUE, WA 98004-3732
- **Practice address phone:** (425) 450-9500
- **Practice address fax:** (425) 450-5008
- **Mailing address:** 1200 112TH AVE NE, C222, BELLEVUE, WA 98004-3732
- **Mailing address phone:** (425) 450-9500
- **Mailing address fax:** (425) 450-5008

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | WA | Yes |
| 1223P0300X | Periodontics | — | WA | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | WA | — |

## Other

- **Enumeration date:** 03/21/2017
- **Last updated:** 03/21/2017