Provider Demographics
NPI:1326637323
Name:KAVITA SUTHAR, DDS, PLLC
Entity Type:Organization
Organization Name:KAVITA SUTHAR, DDS, PLLC
Other - Org Name:REFLECTIONS DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:KAVITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUTHAR
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:919-405-7075
Mailing Address - Street 1:10411 MONCREIFFE RD STE 107
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27617-7820
Mailing Address - Country:US
Mailing Address - Phone:919-405-7075
Mailing Address - Fax:
Practice Address - Street 1:10411 MONCREIFFE RD STE 107
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-7820
Practice Address - Country:US
Practice Address - Phone:401-218-5014
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-13
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental