Provider Demographics
NPI:1609417005
Name:SUNNY, SARAH BETH KURUVILLA (DDS)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:BETH KURUVILLA
Last Name:SUNNY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:BETH
Other - Last Name:KURUVILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4802 LAKE VIEW PKWY
Mailing Address - Street 2:STE 102
Mailing Address - City:ROWLETT
Mailing Address - State:TX
Mailing Address - Zip Code:75088
Mailing Address - Country:US
Mailing Address - Phone:972-402-5789
Mailing Address - Fax:
Practice Address - Street 1:4802 LAKEVIEW PKWY
Practice Address - Street 2:STE 102
Practice Address - City:ROWLETT
Practice Address - State:TX
Practice Address - Zip Code:75088
Practice Address - Country:US
Practice Address - Phone:972-402-5789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2021-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS0424491223G0001X
NMDD52161223G0001X
TX366311223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice