Provider Demographics
NPI:1245953249
Name:IVYARUPA SUNKARA DDS INC
Entity type:Organization
Organization Name:IVYARUPA SUNKARA DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:DIVYARUPA
Authorized Official - Middle Name:
Authorized Official - Last Name:SUNKARA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:510-219-4250
Mailing Address - Street 1:6324 LOOKOUT PASS WAY
Mailing Address - Street 2:
Mailing Address - City:ROCKLIN
Mailing Address - State:CA
Mailing Address - Zip Code:95765-4547
Mailing Address - Country:US
Mailing Address - Phone:510-219-4250
Mailing Address - Fax:
Practice Address - Street 1:2321 NORTHGATE BLVD
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95833-2504
Practice Address - Country:US
Practice Address - Phone:510-219-4250
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-23
Last Update Date:2022-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental