MEDICARE: DIVYARUPA SUNKARA DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	63698	CA

General Provider Information

NPI Number	:	1427457175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DIVYARUPA SUNKARA DDS

Provider Business Mailing Address
First Line	:	5261 ELKHORN BLVD
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95842-2506
Country	:	US
Telephone Number	:	916-344-2554
Fax Number	:	916-339-8150

Provider Business Practice Location Address
First Line	:	2321 NORTHGATE BLVD
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95833-2504
Country	:	US
Telephone Number	:	510-219-4250
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/19/2014
Last Update Date	:	09/23/2022

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