Organization
SUKKAWALA NEVADA DENTAL TEAM, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KETAN SUKKAWALA DDS (OWNER)
(713) 489-2198
Entity
Organization
Contact information
Practice address
4275 BURNHAM AVE STE 101, LAS VEGAS, NV 89119-5400
(702) 470-2948
Mailing address
9709 LAKESIDE BLVD STE 350, SPRING, TX 77381-1216
(713) 489-2198
(713) 489-2978
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
250013104
—
NV
Enumeration date
03/31/2021
Last updated
06/17/2026
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