Sudheer J. Surpure, MD, DDS, Inc.

Primary specialty

Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X

Legal business name

SUDHEER J. SURPURE, MD, DDS, INC.

Practice address

Grand Canyon Oral and Facial Surgery
1600 W. Sunset Road, Suite B
Henderson, NV 89014

Phone

(615) 480-5534

NPI assigned

Oct 6, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Sudheer J. Surpure, MD, DDSNPI 1235216185

Title

President

Phone

(615) 480-5534

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Grand Canyon Oral and Facial Surgery Doing business as

Tax ID family

Grand Canyon Oral and Facial Surgery2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Sudheer J Surpure MD DDS Inc

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Flagstaff, AZ
  • NPI 1023609062
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Sudheer J. Surpure, MD, DDS

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Flagstaff, AZ
  • NPI 1235216185
  NPD Authorized official

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

{
    "created_epoch": "1601942400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1601942400000",
    "number": "1447857024",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 E CASTLE HILLS DR",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860052725",
            "telephone_number": "615-480-5534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "GRAND CANYON ORAL AND FACIAL SURGERY",
            "address_2": "1600 W. SUNSET ROAD, SUITE B",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "89014",
            "telephone_number": "615-480-5534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUDHEER J. SURPURE, MD, DDS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-10-06",
        "last_updated": "2020-10-06",
        "certification_date": "2020-10-03",
        "status": "A",
        "authorized_official_last_name": "SURPURE",
        "authorized_official_first_name": "SUDHEER",
        "authorized_official_middle_name": "J.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "615-480-5534",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD, DDS"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Oral & Maxillofacial Surgery",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1578942488",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Grand Canyon Oral and Facial Surgery",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Katherine Suarez, OT
• Maite Suarez
• Felicia Suberville
• Karthikeyan Subramani, B.D.S., M.SC., M.S
• Success TMS of Nevada PLLC
• Sudhir S Khemka MD, PLLC
• Sue & Associates, PC
• Heather Wiley Suescun, CRNA
• Timothy Katsuhiro Sugimoto, DO
• Mark Vincent Suhany, M.D.

• Oral & Maxillofacial Surgery (D.M.D.) in Henderson, NV
• Providers in Henderson, NV by specialty
• Oral & Maxillofacial Surgery (D.M.D.) in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.