Peiti Su, DDS - Medicare Dentist in Sacramento, CA

Peiti Su, DDS is a medicare enrolled "Dentist - Endodontics" provider in Sacramento, California. Her current practice location is 1721 La Playa Way, Sacramento, California. You can reach out to her office (for appointments etc.) via phone at (916) 432-3431.

Peiti Su is licensed to practice in California (license number 62032) 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 1104055235.

Contact Information

Peiti Su, DDS
1721 La Playa Way,
Sacramento, CA 95864-1508
(916) 432-3431
Not Available



Healthcare Provider's Profile

Full NamePeiti Su
GenderFemale
SpecialityDentist - Endodontics
Location1721 La Playa Way, Sacramento, California
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1104055235
  • Provider Enumeration Date: 07/10/2009
  • Last Update Date: 03/03/2013
  Medicare PECOS Information:
  • PECOS PAC ID: 2668788969
  • Enrollment ID: I20150901002595

Medical Identifiers

Medical identifiers for Peiti Su such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1104055235NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1223E0200XDentist - Endodontics 62032 (California)Primary
1223E0200XDentist - Endodontics 055065-1 (New York)Secondary

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. Peiti Su 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
Peiti Su, DDS
4300 Berrendo Dr,
Sacramento, CA 95864-3120

Ph: (916) 432-3431
Peiti Su, DDS
1721 La Playa Way,
Sacramento, CA 95864-1508

Ph: (916) 432-3431

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