Sara Sue Sturgeon, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12007387B Issued in IN

Practice address

2301 East Third Street
Bloomington, IN 47401-5320

Phone

(812) 332-1406

Fax

(812) 332-6133

NPI assigned

Sep 26, 2006

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

Other names 1

• Sally S Sturgeon Professional name

Medicare fee-for-service enrollment

Enrolled in IN

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": "1159228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376644948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 EAST THIRD STREET",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015320",
            "telephone_number": "812-332-1406",
            "fax_number": "812-332-6133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 EAST THIRD STREET",
            "city": "BLOOMINGTON",
            "state": "IN",
            "postal_code": "474015320",
            "telephone_number": "812-332-1406",
            "fax_number": "812-332-6133"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STURGEON",
        "first_name": "SARA",
        "middle_name": "SUE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12007387B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALLY",
            "last_name": "STURGEON",
            "middle_name": "S",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Jocie Denise Strock
• Deandra Stroud
• Joseph Manford Strunk, RN
• Shelby Strunk
• Conner Sturgeon
• Yu-Ting Su
• Timothy Sudrovech, LCSW
• Sue'S Center Inc
• Sue'S Center LLC
• Cynyrlynne Lola Suganob, PT, DPT

• General Practice Dentistry in Bloomington, IN
• Providers in Bloomington, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.