Healthcare Provider Details

I. General information

NPI: 1801342183
Provider Name (Legal Business Name): HEMA SUNDAR DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/28/2016
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

407 E MAPLE ST
CUMMING GA
30040-2635
US

IV. Provider business mailing address

4028 WINDER HIGHWAY
EDMONTON GA
30542
US

V. Phone/Fax

Practice location:
  • Phone: 678-525-0327
  • Fax:
Mailing address:
  • Phone: 678-217-8591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN015241
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: