# SUKKAWALA NEVADA DENTAL TEAM, PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

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

## Provider details

- **NPI number:** 1528646569
- **Authorized official:** KETAN SUKKAWALA DDS (OWNER)
- **Authorized official phone:** (713) 489-2198

## Contact information

- **Practice address:** 4275 BURNHAM AVE STE 101, LAS VEGAS, NV 89119-5400
- **Practice address phone:** (702) 470-2948
- **Mailing address:** 9709 LAKESIDE BLVD STE 350, SPRING, TX 77381-1216
- **Mailing address phone:** (713) 489-2198
- **Mailing address fax:** (713) 489-2978

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | — | NULL | Yes |
| 122300000X | Dentist | — | — | Yes |

## Other

- **Enumeration date:** 03/31/2021
- **Last updated:** 06/17/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 250013104 | — | NV |