Sumana Anun, DDS
Individual provider Active NPI Dentist · Montclair, CA
NPI 1144360249 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1144360249
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 38641 (CA)
- Practice address
- 5467 Moreno St
Suite a
Montclair, CA 91763-1682 - Phone
- (909) 946-6771
- Fax
- (909) 946-6831
- NPI assigned
- Feb 7, 2007
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 38641 | CA | MD | Marriage & Family Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 38641 | CA | Yes |
Addresses
Primary practice location
5467 Moreno St
Suite a
Montclair, CA 91763-1682
Mailing address
3755 N Grand Ave
Claremont, CA 91711
Phone (909) 624-7712
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| B3864101 | Medicaid | CA |
Other names
- Miss Sumana Anuntalabhochai
Other providers in Montclair, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.