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Contact Information

SUDHEER J SURPURE, MD, DDS
1600 W UNIVERSITY AVE STE 101
FLAGSTAFF, AZ86001-3154
 Phone: 928-247-6200
 Fax: 702-472-8575
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Oral & Maxillofacial Surgery

204E00000X 02 Physician/General Surgery
 

Oral and Maxillofacial Surgery

1223S0112X 19 Oral Surgery (Dentist only)
Indicates primary specialty

NPI Profile & details for SUDHEER J SURPURE · (Male)

NPI # 1235216185
Status Active
Credentials MD, DDS
Entity Individual
Enumeration date 10/31/2006
Last updated 10/13/2023 - About 3 years ago
Sole proprietor 1 Yes
Identifiers
  • AZ License # 41157
  • CA License # A92044
  • CA License # OMS 89
  • OK License # OMFS SPECIALTY 157
  • CA Medicaid 00A920440
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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