Surpure, Sudheer J.
Surpure, Sudheer J. is an sole proprietor health care provider with primary practice located at 1600 W University Ave Ste 101 , Flagstaff AZ 86001-3154. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery is his primary health care specialty. Surpure, Sudheer J. can be contacted via phone (928) 247-6200.Contact Information
Primary practice address
1600 W University Ave Ste 101
Flagstaff AZ 86001-3154
Phone: (928) 247-6200
Fax: (702) 472-8575
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | OMS 89 | California |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | OMFS SPECIALTY 157 | Oklahoma |
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | 41157 | Arizona |
| Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery | 204E00000X | A92044 | California |
Profile Details
| NPI number | 1235216185 |
|---|---|
| LBN Legal business name | Surpure, Sudheer J. |
| Credentials | MD, DDS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 31st, 2006 |
| Last updated | Oct 13th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1235216185 | NPPES |
| California | MEDICAID | 00A920440 |
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