David Sullivan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9503 Issued in NC

Practice address

5833 Phyliss LN
Mint Hill, NC 28227-9031

Phone

(704) 568-8010

NPI assigned

Mar 11, 2013

Last updated

Nov 6, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1362960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1415232000000",
    "number": "1023359312",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5833 PHYLISS LN",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282279031",
            "telephone_number": "704-568-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5833 PHYLISS LN",
            "city": "MINT HILL",
            "state": "NC",
            "postal_code": "282279031",
            "telephone_number": "704-568-8010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-11",
        "last_updated": "2014-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9503",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Steven J Leighton
• Kristy Stevens
• Hailey Anne Stewart, PHARMD
• Saisahana Subburaj, RN
• Sullivan Burd Roupas & Ross DDS PLLC (East Charlotte Dental Clinic)
• Kenisha Best Sullivan, RN
• Farrah Swinton
• Tabonuco Counseling and Consulting PLLC
• Tall Family Services, Inc.
• Sadie Ann Tallbacka, DMD

• General Practice Dentistry in Mint Hill, NC
• Providers in Mint Hill, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.