Supritha Shetty Komarisetty

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

42546 Issued in TX

Practice address

309 NE Georgia Ave # 124
Sweetwater, TX 79556-8246

Phone

(325) 236-6902

NPI assigned

May 15, 2026

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1778803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782950400000",
    "number": "1184553257",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "309 NE GEORGIA AVE # 124",
            "city": "SWEETWATER",
            "state": "TX",
            "postal_code": "795568246",
            "telephone_number": "325-236-6902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "309 NE GEORGIA AVE # 124",
            "city": "SWEETWATER",
            "state": "TX",
            "postal_code": "795568246",
            "telephone_number": "325-236-6902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOMARISETTY",
        "first_name": "SUPRITHA SHETTY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-05-15",
        "last_updated": "2026-07-02",
        "certification_date": "2026-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "42546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hubbard Creek Two
• Ira Isd
• Sonya D Ivy, LVN
• Frederick John Kassis, M.D.
• David R King, DC
• L.R. Moses, DO, Association
• Deborah Lancaster, D.C.
• LDH, PC
• Jennifer Gail Sinclair Liedtke, MD
• George Crockett Lindsey, D.O.

• General Practice Dentistry in Sweetwater, TX
• Providers in Sweetwater, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.