Healthcare Provider Details

I. General information

NPI: 1730047366
Provider Name (Legal Business Name): DR. SUNIDHI KHUTETA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

146 HIGH ST
IPSWICH MA
01938-1212
US

IV. Provider business mailing address

68 PLYMOUTH DR APT 2A
NORWOOD MA
02062-5471
US

V. Phone/Fax

Practice location:
  • Phone: 978-276-9990
  • Fax:
Mailing address:
  • Phone: 774-464-5203
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN10001648
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: