Provider Demographics
NPI:1497979157
Name:MURTHY, SUNITHA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SUNITHA
Middle Name:
Last Name:MURTHY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 PAINE CT
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-7921
Mailing Address - Country:US
Mailing Address - Phone:201-452-9352
Mailing Address - Fax:
Practice Address - Street 1:15 BROADWAY
Practice Address - Street 2:SUITE 202
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-5007
Practice Address - Country:US
Practice Address - Phone:201-452-9352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22928122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0263095Medicaid