Provider Demographics
NPI:1730587601
Name:STERLING SMILES
Entity type:Organization
Organization Name:STERLING SMILES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:MUKUNDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOGIPARTHI
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-526-6831
Mailing Address - Street 1:76 NORTHEASTERN BLVD
Mailing Address - Street 2:#29B
Mailing Address - City:NASHUA
Mailing Address - State:NH
Mailing Address - Zip Code:03062-3174
Mailing Address - Country:US
Mailing Address - Phone:603-459-8127
Mailing Address - Fax:
Practice Address - Street 1:76 NORTHEASTERN BLVD
Practice Address - Street 2:#29B
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03062-3174
Practice Address - Country:US
Practice Address - Phone:603-459-8127
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-09
Last Update Date:2014-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH03547122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3083467Medicaid