Alexander Sukhorukov, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9673 Issued in KY

Practice address

4420 Dixie Hwy Ste 110
Louisville, KY 40216-2986

Phone

(502) 447-3323

Fax

(913) 752-9116

NPI assigned

Aug 24, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

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": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540857600000",
    "number": "1902273139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1105 CLIFTY DR",
            "city": "MADISON",
            "state": "IN",
            "postal_code": "472501614",
            "telephone_number": "812-273-0207",
            "fax_number": "812-273-3366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4420 DIXIE HWY STE 110",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402162986",
            "telephone_number": "502-447-3323",
            "fax_number": "913-752-9116"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1105 Clifty Dr",
            "address_purpose": "LOCATION",
            "city": "Madison",
            "state": "IN",
            "postal_code": "472501614",
            "country_code": "US",
            "telephone_number": "812-273-0207",
            "fax_number": "812-273-3366",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SUKHORUKOV",
        "first_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-24",
        "last_updated": "2018-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9673",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12012414A",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Nicole Suell
• Sugarite Dialysis LLC (Shelbyville Road Dialysis)
• Kathleen Sugg, SLP.D, CCC-SLP
• Lynda A Sugg, ARNP MSN
• Cocanut Mohammed Suhail, PHARMD
• Touqeer A Sulehria, MD
• Faisal Suleman
• Sajida Suleman
• Sally A Suliman, M.D
• Gregory Michael Sulkowski, M.D.

• General Practice Dentistry in Louisville, KY
• Providers in Louisville, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2018; 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.