Provider Demographics
NPI:1952392730
Name:NANJAPPA, SUNITHA (DDS)
Entity Type:Individual
Prefix:
First Name:SUNITHA
Middle Name:
Last Name:NANJAPPA
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 1:173 ESSEX AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:METUCHEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08840-2281
Mailing Address - Country:US
Mailing Address - Phone:732-662-3567
Mailing Address - Fax:
Practice Address - Street 1:173 ESSEX AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:METUCHEN
Practice Address - State:NJ
Practice Address - Zip Code:08840-2281
Practice Address - Country:US
Practice Address - Phone:732-662-3567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI019018001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics