Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Sara Supriyatno, DDS

Individual provider General Practice Dentistry · NPI 1225775778

Sara Supriyatno, DDS is a General Practice Dentistry in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2022.

Licensed in
PA
In the registry since
2022
Specialties on file
2
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

909 Walnut St Rm 300
Philadelphia, PA 19107-5211
Phone: (215) 503-7118
Fax: (215) 923-9189
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
General Practice Dentistry Taxonomy 1223G0001X · Licence DS043687 (PA)

Record details

NPI number1225775778
Entity typeIndividual (Type 1)
GenderFemale
Credentials DDS
Sole proprietorNo
NPI enumeratedMay 17, 2022
Last updated in NPPESJanuary 9, 2024
Certification dateJanuary 9, 2024

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