Provider Demographics
NPI:1417117474
Name:PARAKKAL, SUMA (DMD)
Entity Type:Individual
Prefix:DR
First Name:SUMA
Middle Name:
Last Name:PARAKKAL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 CARTER ST
Mailing Address - Street 2:UNIT 208
Mailing Address - City:EVERETT
Mailing Address - State:MA
Mailing Address - Zip Code:02149-2523
Mailing Address - Country:US
Mailing Address - Phone:617-763-4558
Mailing Address - Fax:
Practice Address - Street 1:375 AMHERST ST STE 2
Practice Address - Street 2:
Practice Address - City:NASHUA
Practice Address - State:NH
Practice Address - Zip Code:03063-1216
Practice Address - Country:US
Practice Address - Phone:603-595-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-12
Last Update Date:2008-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22129122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist