Provider Demographics
NPI:1548710221
Name:SUNSHINE DENTISTRY
Entity type:Organization
Organization Name:SUNSHINE DENTISTRY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OW
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAVITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAPOLU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-497-5252
Mailing Address - Street 1:12121 RICHMOND AVE
Mailing Address - Street 2:STE 426
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77082-2432
Mailing Address - Country:US
Mailing Address - Phone:281-497-5252
Mailing Address - Fax:281-497-1303
Practice Address - Street 1:12121 RICHMOND AVE
Practice Address - Street 2:STE 426
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77082-2432
Practice Address - Country:US
Practice Address - Phone:281-497-5252
Practice Address - Fax:281-497-1303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty