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General NPI Number Information
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NPI Number | 1023071396
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Entity Type | Individual
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Provider Name | SUMATHI CHANDRASHEKHAR DMD
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Gender | Female
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Dates
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Enumeration Date | 04/08/2006
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Last Update Date | 04/20/2023
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Provider Practice Location Address
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Address Line | 5017 TEASLEY LN STE 165
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City | DENTON
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State | TX
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Zip | 76210-3895
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Country | US
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Telephone | 214-218-5543
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Fax |
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Provider Business Mailing Address
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Address Line | 106 FOREST BEND DR
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City | COPPELL
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State | TX
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Zip | 75019-2039
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Country | US
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Telephone | 214-218-5543
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 0496581
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI02169000
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 56055
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License Number State | CA
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Taxonomy #4
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 31426
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License Number State | TX
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