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SUDHEER J. SURPURE MD DDS NPI 1235216185


NPI Information

NPI: 1235216185
Provider Name: SUDHEER J. SURPURE, MD, DDS
Classification: Oral & Maxillofacial Surgery - 204E00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1600 W UNIVERSITY AVE STE 101
FLAGSTAFF, AZ
ZIP 86001
Phone: (928) 247-6200
Get Directions

Sudheer J. Surpure, MD, DDS is an oral maxillofacial surgery in Flagstaff, AZ. The provider is oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery. Sudheer J. Surpure, MD, DDS NPI is 1235216185. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1600 W UNIVERSITY AVE STE 101
FLAGSTAFF, AZ
ZIP 86001-154
Phone: (928) 247-6200
Fax: (702) 472-8575

The NPI 1235216185 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/31/2006 and was last updated on 10/13/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223S0112XDentistOral and Maxillofacial SurgeryOMS 89CALIFORNIANo
21223S0112XDentistOral and Maxillofacial SurgeryOMFS SPECIALTY 157OKLAHOMANo
3204E00000XOral & Maxillofacial Surgery41157ARIZONANo
4204E00000XOral & Maxillofacial SurgeryA92044CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100A920440MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.