Miss Sura Al Obaidy, - Medicare Dentist in San Diego, CA

Miss Sura Al Obaidy, is a medicare enrolled "Dentist - General Practice" provider in San Diego, California. Her current practice location is 4142 Adams Ave Ste 104, San Diego, California. You can reach out to her office (for appointments etc.) via phone at (619) 483-7977.

Miss Sura Al Obaidy is licensed to practice in California (license number DDS107910) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1124771811.

Contact Information

Miss Sura Al Obaidy,
4142 Adams Ave Ste 104,
San Diego, CA 92116-2594
(619) 483-7977
Not Available



Healthcare Provider's Profile

Full NameMiss Sura Al Obaidy
GenderFemale
SpecialityDentist - General Practice
Location4142 Adams Ave Ste 104, San Diego, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1124771811
  • Provider Enumeration Date: 02/02/2022
  • Last Update Date: 03/03/2023
  Medicare PECOS Information:
  • PECOS PAC ID: 2860857257
  • Enrollment ID: I20230509001126

Medical Identifiers

Medical identifiers for Miss Sura Al Obaidy such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1124771811NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223G0001XDentist - General Practice DDS107910 (California)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Miss Sura Al Obaidy is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Miss Sura Al Obaidy,
6255 Rancho Mission Rd Unit 306,
San Diego, CA 92108-1822

Ph: (619) 483-7977
Miss Sura Al Obaidy,
4142 Adams Ave Ste 104,
San Diego, CA 92116-2594

Ph: (619) 483-7977

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