More than 130 people were seriously injured in the Saturday morning quake in East Nusa Tenggara province, Deputy Health Minister Benjamin Paulus Octavianus told a televised meeting on Sunday.
The quake, followed by nearly 1000 aftershocks, is the Southeast Asian nation's worst in years. Hundreds died after a 2022 earthquake in West Java.
Tsunami waves of less than one metre were recorded in several parts of the Southeast Asian nation after the early morning quake.
Authorities lifted a tsunami warning about three hours later.
More than 3300 people in the Sikka region self-evacuated or were stranded in a sports arena, the disaster mitigation agency BNPB said.
Some Sikka residents were stranded outside collapsed homes under a makeshift tent made out of tarp, while some people received treatment in a tent outside a hospital in the port town of Maumere.
"I only brought my body," Abdul Mutas, 63, told Reuters after he and his family slept on a tarp surrounded by trees in the town of Sikka.
"The tides were rising, so we ran," he said, describing their reaction to the quake.
"Almost all of Sikka's residents didn't dare stay indoors, so they slept on a porch or a tent outside," deputy regent of Sikka Simon Subandi told news channel KompasTV.
More than 3500 military and police officers have been deployed to the region, Cabinet Secretary Teddy Indra Wijaya said in a statement.
Rescuers were able to access parts of Maumere that had been blocked by landslides, Indonesia's search and rescue agency said.
Most of those missing were trapped under rubble, and more than 1300 homes were damaged, BNPB said.
Twenty petrol stations were not operational due to power outages, state energy firm Pertamina said.
The East Nusa Tenggara government is considering declaring an emergency for the province, BNPB said, which would allow authorities to mobilise resources and funding.
Indonesian geophysics agency recorded the first quake at a depth of 15km, followed by several aftershocks.
The agency said the same area was hit by a magnitude 7.5 earthquake in 1992 that caused extensive destruction.
Australia's tsunami warning centre said the undersea quake had posed "no tsunami threat to the Australian mainland, islands or territories".
Indonesia straddles the Pacific Ring of Fire, a seismically active zone where tectonic plates meet, triggering frequent earthquakes and volcanic eruptions.
In 2018, a magnitude 7.5 earthquake and tsunami struck the city of Palu on Sulawesi Island, killing more than 4000 people.
with AP