Healthcare Provider Details

I. General information

NPI: 1720239361
Provider Name (Legal Business Name): SMILEN DENTAL GROUP, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/01/2008
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44 S TURNPIKE RD
WALLINGFORD CT
06492-3458
US

IV. Provider business mailing address

44 S TURNPIKE RD
WALLINGFORD CT
06492-3458
US

V. Phone/Fax

Practice location:
  • Phone: 203-774-0019
  • Fax:
Mailing address:
  • Phone: 203-774-0019
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: SULAKSHANA SUNDARESAN
Title or Position: CO-OWNER/PRESIDENT
Credential: DDS
Phone: 203-774-0019