Healthcare Provider Details

I. General information

NPI: 1366309940
Provider Name (Legal Business Name): MOHANA SAI MOUNIKA SUNKU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/06/2026
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2022 CHERRY RD
ROCK HILL SC
29732-2627
US

IV. Provider business mailing address

8027 SCARLET MAPLE LN
TEGA CAY SC
29708-8718
US

V. Phone/Fax

Practice location:
  • Phone: 803-324-9400
  • Fax:
Mailing address:
  • Phone: 781-535-3079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number11515
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: