Provider Demographics
NPI:1568344828
Name:SUN DENTAL GROUP PLLC
Entity type:Organization
Organization Name:SUN DENTAL GROUP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:SAVITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:YANNAM
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:603-943-4594
Mailing Address - Street 1:1201 S W S YOUNG DR STE D
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76543-4887
Mailing Address - Country:US
Mailing Address - Phone:254-690-3380
Mailing Address - Fax:254-690-3668
Practice Address - Street 1:1201 S W S YOUNG DR STE D
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-4887
Practice Address - Country:US
Practice Address - Phone:254-690-3380
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty