Provider Demographics
NPI:1952122160
Name:NUSMILE STUDIO PLLC
Entity type:Organization
Organization Name:NUSMILE STUDIO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SUMITA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAKRABORTI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:512-619-3514
Mailing Address - Street 1:3907 JOHN SIMPSON TRL
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78732-2265
Mailing Address - Country:US
Mailing Address - Phone:512-619-3514
Mailing Address - Fax:
Practice Address - Street 1:1213 RANCH ROAD 620 S STE 205
Practice Address - Street 2:
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-6347
Practice Address - Country:US
Practice Address - Phone:512-619-3514
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental