SUEGOL SADRI (DDS) – General Practice Dentistry, NPI 1003659673

SUEGOL SADRI (DDS) is a healthcare provider. based in Clinton, Missouri. specializing in DENTIST. They hold the professional credentials DDS. They hold a License No. 2024019731 (MO). The NPI Number for SUEGOL SADRI (DDS) is 1003659673

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
SUEGOL SADRI (DDS)
NPI
1003659673
Phone
(660) 885-8131
Address
1800 COMMUNITY
Enumeration Date
13 June 2024
Last Update Date
13 June 2024

Doctor Profile

Medical School Name
UNIV OF MISSOURI-KANSAS CITY SCHOOL OF DENTISTRY
Secondary Phone
5732142314
Graduation Year
2024 (2 years ago)
PAC ID
3971047291
Group Practice PAC ID
1951206754
Professional Enrollment ID
I20240627002896
Address ID
MO652032037CO1001XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

52 DENTIST in MO

Provider Addresses for SUEGOL SADRI (DDS)

  • 1800 COMMUNITY

    CLINTON, MO 647358804

    Phone: (660) 885-8131

    Type: Mailing

  • 1845 JEFFCO BLVD

    ARNOLD, MO 630102714

    Phone: (844) 853-8937

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-06-27

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240627002896IDentistMOTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 64735)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1951206754View full group profile

Reviews

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Frequently asked questions

What is the registry number for SUEGOL SADRI (DDS)?
The registry entry for SUEGOL SADRI (DDS) shows NPI 1003659673.
Is SUEGOL SADRI (DDS)'s NPI status active today?
Active status means SUEGOL SADRI (DDS)'s NPI record is not deactivated in the public file.
What type of care does SUEGOL SADRI (DDS) provide?
SUEGOL SADRI (DDS)'s profile centers on General Practice Dentistry. Clinical services aligned with this taxonomy classification.
Which community is linked to SUEGOL SADRI (DDS)?
SUEGOL SADRI (DDS) shows a connection to Clinton, Missouri in registry-derived data.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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