Provider Demographics
NPI:1518446129
Name:BELGRAVE, SUNAINA
Entity Type:Individual
Prefix:
First Name:SUNAINA
Middle Name:
Last Name:BELGRAVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 AUSTIN ST APT 1008
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77002-7798
Mailing Address - Country:US
Mailing Address - Phone:862-754-0630
Mailing Address - Fax:
Practice Address - Street 1:10009 BROADWAY ST STE 107
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-9757
Practice Address - Country:US
Practice Address - Phone:281-699-8744
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-14
Last Update Date:2023-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12597122300000X
NJ22DI02728700122300000X
TX38810122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist