Surya Joseph

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

D11098 Issued in OR

Practice address

2787 NW Daysha Dr
Roseburg, OR 97471-2980

Phone

(404) 939-5152

NPI assigned

Aug 26, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Surya Joseph Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1472169600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731283200000",
    "number": "1992251391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2787 NW DAYSHA DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712980",
            "telephone_number": "404-939-5152"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2787 NW DAYSHA DR",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974712980",
            "telephone_number": "404-939-5152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOSEPH",
        "first_name": "SURYA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-26",
        "last_updated": "2024-11-11",
        "certification_date": "2024-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OR",
            "license": "D11098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SURYA",
            "last_name": "JOSEPH",
            "prefix": "DR.",
            "credential": "DMD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Stephanie Jean Jones, SLP
• Elena Ruth Jordan, MD
• Jorgensen Family Medicine PC
• Layne S Jorgensen, DO
• Steven L Jorgensen, DO
• Shashank Joshi, BDS, MS
• Joshua Fisher MD MPH MSC PC
• Rachel Suzanne Judd
• Judith a Martin L.C.S.W., P.C.
• Jared E Juett, LCSW

• Orthodontics and Dentofacial Orthopedics Dentistry in Roseburg, OR
• Providers in Roseburg, OR by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2024; 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.