Sura Al Obaidy

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DDS107910 Issued in CA

Practice address

4142 Adams Ave Ste 104
San Diego, CA 92116-2594

Phone

(619) 483-7977

NPI assigned

Feb 2, 2022

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1643760000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677801600000",
    "number": "1124771811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 RANCHO MISSION RD UNIT 306",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081822",
            "telephone_number": "619-483-7977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4142 ADAMS AVE STE 104",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921162594",
            "telephone_number": "619-483-7977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AL OBAIDY",
        "first_name": "SURA",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-02",
        "last_updated": "2023-03-03",
        "certification_date": "2023-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "DDS107910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mina Al Doori
• Buraq Al Ghaieb, MD
• Helen Hanna Shaba Al Hnoq
• Leen Al Jamaly
• Belal Outhman Al Khiami, MD
• Baker Al Rawi
• Layth Al Saud, CNIM
• Khaled Al Tawil
• Mohammed Al Tekreeti, DMD
• Abdallah Hussein Al Thahabi

• General Practice Dentistry in San Diego, CA
• Providers in San Diego, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.