SUDHEER J. SURPURE, MD, DDS, INC. (NPI# 1447857024) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447857024 |
| Entity Type | Organization |
| Organization Name | SUDHEER J. SURPURE, MD, DDS, INC. |
| Practice Address |
Grand Canyon Oral and Facial Surgery 1600 W. Sunset Road, Suite B Henderson NV 89014 |
| Mailing Address |
1620 E Castle Hills Dr Flagstaff AZ 86005-2725 |
| Practice Telephone | 6154805534 |
| Mailing Telephone | 6154805534 |
| Enumeration Date | 2020-10-06 |
| Last Update Date | 2020-10-06 |
| Authorized Official Name | DR. SUDHEER J. SURPURE (PRESIDENT) |
| Authorized Official Telephone | 6154805534 |
| Authorized Official Credential | MD, DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 204E00000X | Oral & Maxillofacial Surgery | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NPI | 1578942488 | 01 |
| Other Name | Type Code |
|---|---|
| Grand Canyon Oral and Facial Surgery | Doing Business As Name - Organization |
| Street Address |
GRAND CANYON ORAL AND FACIAL SURGERY 1600 W. SUNSET ROAD, SUITE B |
| City | HENDERSON |
| State | NV |
| Zip Code | 89014 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386271740 | Fibonacci Services LLC | Counselor | 2920 N. Green Valley Pkwy, Bulding 8 & Suite 812, Henderson, NV 89014 | 2020-03-25 |
| 1508409145 | Facial Expressions Presented By K. Thomas | Home Infusion | 1520 W. Sunset Rd. Ste 130, #205, Henderson, NV 89014 | 2019-10-27 |
| 1235794595 | Marquise D Dennis | Prosthetist | 1520 W. Sunset Rd, Henderson, NV 89014 | 2019-05-02 |
| 1609359165 | Kenisha Voncille Thomas | Family Medicine | 1520 W Sunset Rd Ste 130, Henderson, NV 89014 | 2018-09-11 |
| 1841716727 | Logan Bretney | Physical Therapist | 400 S Stephanie St, Suite 310, Building 1, Henderson, NV 89014 | 2017-08-22 |
| 1912421280 | Alan Joseph Sevy | Dentist | 1485 W Warm Springs Rd Ste 101, Henderson, NV 89014 | 2017-07-28 |
| 1659805307 | Ann Marie Echevarria | Behavior Technician | 2551 N Green Valley Parkway, 410a, Henderson, NV 89014 | 2017-04-19 |
| 1366838997 | Ladwana Retic, Lcsw LLC | Case Management | 1514 Tree Top Ct, Henderson, NV 89014 | 2015-04-10 |
| 1073958393 | Ashlyn Call | Physician Assistant | 1397 Galleria Dr Ste 100, Henderson, NV 89014 | 2013-04-30 |
| 1275870610 | Devendranath Mahender Nath | Pharmacist | 1000 N Gv Pkwy, Henderson, NV 89014 | 2013-01-04 |
| Find all providers in zip 89014 | ||||
| Taxonomy Code | 204E00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Oral & Maxillofacial Surgery |
| 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. |
| Notes: Source: American College of Surgeons, 2013. www.facs.org [7/1/2013: definition added, source added, additional resources added] Additional Resources: American Board of Oral and Maxillofacial Surgery and American Association of Oral and Maxillofacial Surgeons While this is generally considered a specialty of dentistry, physicians can also be board certified as oral and maxillofacial surgeons through the American Board of Oral and Maxillofacial Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174570816 | Katherine A Keeley | Oral & Maxillofacial Surgery | 2649 Wigwam Pkwy, Suite 102, Henderson, NV 89074-7310 | 2006-05-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053595579 | Mark L Glyman Md Dds & Eric D Swanson Md Dmd Ltd | Oral & Maxillofacial Surgery | 2030 E Flamingo Rd Ste 288, Las Vegas, NV 89119-5163 | 2007-12-19 |
| 1801953401 | Scott Michael Boyden | Oral & Maxillofacial Surgery | 4101 Caughlin Square #5, Reno, NV 89519 | 2007-01-02 |
| 1033289327 | Christopher John Hussar | Oral & Maxillofacial Surgery | 9408 Double R Blvd, Suite A, Reno, NV 89521-5977 | 2006-11-08 |
| 1235106063 | Thomas Joseph Melendrez | Oral & Maxillofacial Surgery | 757 W 7th St Ste 102, Reno, NV 89503-3672 | 2006-03-01 |
| 1154640316 | Christopher Joseph Galea | Oral & Maxillofacial Surgery | 290 Brinkby Ave, Reno, NV 89509 | 2010-05-26 |
| 1831256627 | Thomas Wong | Oral & Maxillofacial Surgery | 6900 Pecos Rd, North Las Vegas, NV 89086-4400 | 2007-01-02 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.