Duane Mathew Sushoreba, D.D.S.
Individual provider Active NPI General Practice Dentistry · Cook, MN
NPI 1689649386 · NPPES record last updated Jul 13, 2026
Key facts
- NPI
- 1689649386
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D8861 (MN)
- Practice address
- 20 5TH St SE
Cook, MN 55723-9702 - Phone
- (218) 666-5958
- Fax
- (218) 666-5099
- NPI assigned
- Feb 17, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161118000655 | MN | Order and Referring Only - Dentist |
6709165582 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cook Area Health Services, Inc | Past | Accepting new patients | |
| Cook Area Health Services, Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D8861 | MN | Yes |
Addresses
Primary practice location
20 5TH St SE
Cook, MN 55723-9702
Mailing address
20 5TH St SE
Dental
Cook, MN 55723-9702
Phone (218) 666-5958
Other providers in Cook, MN
- Louis Frank Pius
- Ehab Aly Nour Rezk
- Carrie Sell
- Elizabeth Simensen
- Timothy Sprouls
- Michael Morris Talberg
- True Care Medical Therapy Center Inc
- Turning Point Counseling PA
- Fred Lawrence Webber
- Kiara Westendorf
All providers in Cook, MN · General Practice Dentistry in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.