# SUN DENTAL SPECIALTY, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154910412
- **Authorized official:** DR. NISHITA IRUKULLA DDS (PRESIDENT)
- **Authorized official phone:** (609) 233-6672

## Contact information

- **Practice address:** 7419 NEW FALLS RD, LEVITTOWN, PA 19055-1008
- **Practice address phone:** (215) 945-5199
- **Practice address fax:** (215) 945-6290
- **Mailing address:** 7419 NEW FALLS RD, LEVITTOWN, PA 19055-1008
- **Mailing address phone:** (215) 945-5199
- **Mailing address fax:** (215) 945-6290

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223E0200X | Endodontics | — | NULL | — |
| 1223E0200X | Endodontics | — | — | — |
| 1223P0700X | Prosthodontics | — | NULL | — |
| 1223P0700X | Prosthodontics | — | — | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | NULL | Yes |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | — | — | Yes |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | NULL | — |
| 1223X0400X | Orthodontics and Dentofacial Orthopedics Dentistry | — | — | — |

## Other

- **Enumeration date:** 01/12/2021
- **Last updated:** 01/14/2021