George Washington Surguy, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

12008621 Issued in IN

Practice address

521 East Monroe Street
South Bend, IN 46601-2325

Phone

(574) 234-1700

Fax

(574) 287-6453

NPI assigned

Jan 29, 2007

Sex

Male

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 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

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Associated Riverbend Dentists PC

  • Dentist
  • South Bend, IN
  • NPI 1568503902
  NPD (past) Authorized official

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1740326636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 EAST MONROE STREET",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466012325",
            "telephone_number": "574-234-1700",
            "fax_number": "574-287-6453"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 EAST MONROE STREET",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466012325",
            "telephone_number": "574-234-1700",
            "fax_number": "574-287-6453"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SURGUY",
        "first_name": "GEORGE",
        "middle_name": "WASHINGTON",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IN",
            "license": "12008621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rajalakshmy Sundararajan, MD
• Julie Ann Sunday, DPT
• Sunnyside Pediatric Therapy LLC
• Superior Van & Mobility
• Surgery Center Anesthsia
• Emily Wynn Sussman, LCSW
• Martha Suter
• Mary Elizabeth Sutherland, MD
• Bobbie Sutton, M.D.
• Thomas Lynn Sutula, M.D.

• All providers in South Bend, IN
• Dentist 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.