SUDHEER J. SURPURE MD, DDS
NPI 1235216185
Oral & Maxillofacial Surgery in Flagstaff, AZ

Active since October 31, 2006PECOS EnrolledAccepts Medicare Assignment
1600 W UNIVERSITY AVE STE 101, FLAGSTAFF, AZ 86001(928) 247-6200(702) 472-8575 Get Directions Write a Review

NPPES record last updated: October 13, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Sudheer J. Surpure Md, Dds NPPES

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

SUDHEER J. SURPURE MD, DDS (NPI 1235216185) is an individual oral & maxillofacial surgery provider in Flagstaff, Arizona, licensed in California (A92044) and active in the NPI registry since October 2006. He is enrolled in Medicare PECOS and is a graduate of Vanderbilt University School Of Medicine (2002).

NPPES Registry Identity

NPI1235216185
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameSUDHEER J. SURPURECredential: MD, DDS
Location Address1600 W UNIVERSITY AVE STE 101Flagstaff, AZ 86001-3154
Mailing Address1600 W University Ave Ste 101Flagstaff, AZ 86001-3154 · (928) 247-6200 · Fax (602) 957-3282
Fax(702) 472-8575
Sole ProprietorYes
Medical School CMSVanderbilt University School Of MedicineGraduated 2002
Enumeration DateOctober 31, 2006
Last NPPES UpdateOctober 13, 2023
NPPES CertifiedOctober 13, 2023
NPI 1235216185 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
Licenses Licensed in CA · A92044 Licensed in AZ · 41157
Definition

Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.

Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License OMS 89 (CA), OMFS SPECIALTY 157 (OK)
1600 W UNIVERSITY AVE STE 101, Flagstaff, AZ 86001

Other Identifiers 1

Medicaid00A920440CA

Accepted Insurance

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Sudheer J. Surpure Md, Dds is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3971538398
PECOS Enrollment IDI20100210000250
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.

Other Providers at the Same Location NPPES

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

Oral & Maxillofacial Surgery
1600 W UNIVERSITY AVE STE 101
FLAGSTAFF, AZ 86001

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1235216185, enumerated as an "individual" on October 31, 2006.

The provider is located at 1600 W UNIVERSITY AVE STE 101 FLAGSTAFF, AZ 86001 and the phone number is (928) 247-6200.

Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

The provider might be accepting Accepts: BEST Life, Blue Cross and Blue Shield of Montana,. Please consult your insurance carrier or call the provider to verify.