Healthcare Provider Details

I. General information

NPI: 1821963117
Provider Name (Legal Business Name): MRS DENTAL, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/07/2025
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 S IH 35 STE E400
AUSTIN TX
78748-1990
US

IV. Provider business mailing address

9500 S IH 35 STE E400
AUSTIN TX
78748-1990
US

V. Phone/Fax

Practice location:
  • Phone: 512-669-5305
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: MARRINA RAN-SUKKAWALA
Title or Position: PRESIDENT
Credential: DDS, MS
Phone: 916-429-5355