MISS SURA AL OBAIDY
NPI 1124771811
Dentist - General Practice in San Diego, CA

Q: What is Sura Al Obaidy's NPI number?

The NPI number for Sura Al Obaidy is 1124771811. It was assigned to this individual provider in the NPPES registry on February 2, 2022.

Q: What is Sura Al Obaidy's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Sura Al Obaidy was last updated on March 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since February 02, 2022PECOS Enrolled

4142 ADAMS AVE STE 104, SAN DIEGO, CA 92116(619) 483-7977 Get Directions Write a Review

NPPES record last updated: March 3, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 3, 2023, Feb 2, 2022 (2 updates tracked since 2022).

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About Miss Sura Al Obaidy NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS SURA AL OBAIDY (NPI 1124771811) is an individual general practice provider in San Diego, California, licensed in California (DDS107910) and active in the NPI registry since February 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124771811

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameMISS SURA AL OBAIDY

Location Address4142 ADAMS AVE STE 104San Diego, CA 92116-2594

Mailing Address6255 Rancho Mission Rd Unit 306San Diego, CA 92108-1822 · (619) 483-7977

Phone(619) 483-7977

Sole ProprietorNo

Enumeration DateFebruary 2, 2022

Last NPPES UpdateMarch 3, 20232 updates tracked since enumeration

NPPES CertifiedMarch 3, 2023

✔ NPI 1124771811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in CA · DDS107910

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

4142 ADAMS AVE STE 104, San Diego, CA 92116

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miss Sura Al Obaidy is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92116 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.87 typical visit price

range $62.10 – $184.71

Typical copayment $23.71 (range $15.52 – $46.17)

Most-billed visit code 99203

Established Patient

$76.87 typical visit price

range $20.62 – $151.42

Typical copayment $19.21 (range $5.15 – $37.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMILY WEN-HUI WU DMD

Dentist

4142 ADAMS AVE STE 104
SAN DIEGO, CA 92116

San Diego County (619) 326-0157

SAMANTHA YEVGENYEVNA BERGERON DDS

Dentist

4142 ADAMS AVE STE 104
SAN DIEGO, CA 92116

San Diego County (619) 326-0157

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sura Al Obaidy's NPI number?

The NPI number for Sura Al Obaidy is 1124771811. It was assigned to this individual provider in the NPPES registry on February 2, 2022.

Where is Sura Al Obaidy located?

Sura Al Obaidy practices at 4142 Adams Ave Ste 104, San Diego, CA 92116. The listed phone number is (619) 483-7977.

What is Sura Al Obaidy's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Sura Al Obaidy enrolled in Medicare?

Yes. Sura Al Obaidy is registered in the Medicare PECOS enrollment system.

What insurance does Sura Al Obaidy accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma and Blue Cross and Blue Shield of Texas and 5 other insurers list Sura Al Obaidy as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sura Al Obaidy was last updated on March 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.