Healthcare Provider Details

I. General information

NPI: 1811808058
Provider Name (Legal Business Name): STARLINE DENTAL CARE, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2026
Last Update Date: 09/16/2026
Certification Date: 09/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8529 GUNN HWY
ODESSA FL
33556-3288
US

IV. Provider business mailing address

11110 SUNDRIFT DR
TAMPA FL
33647-3858
US

V. Phone/Fax

Practice location:
  • Phone: 689-210-7489
  • Fax:
Mailing address:
  • Phone: 732-874-2637
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: SRAVANTHI KANTA
Title or Position: PRACTICE OWNER
Credential: DMD
Phone: 732-874-2637