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Organization
SUN DENTAL SPECIALTY, LLC
Active
Organization
SUN DENTAL SPECIALTY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NISHITA IRUKULLA DDS (PRESIDENT)
(609) 233-6672
Entity
Organization
Contact information
Practice address
7419 NEW FALLS RD, LEVITTOWN, PA 19055-1008
(215) 945-5199
(215) 945-6290
Mailing address
7419 NEW FALLS RD, LEVITTOWN, PA 19055-1008
(215) 945-5199
(215) 945-6290
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
—
NULL
1223E0200X
Endodontics
—
—
1223P0700X
Prosthodontics
—
NULL
1223P0700X
Prosthodontics
—
—
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
NULL
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
NULL
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
—
—
Other
Enumeration date
01/12/2021
Last updated
01/14/2021
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