Individual provider Active NPI

Margaret Lucretia Sullivan, DDS

  • General Practice Dentistry
  • Avon Lake, OH
National Provider Identifier
1043890296
Registry record updated Mar 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.027160 Issued in OH
Practice address
33398 Walker Rd Ste a
Avon Lake, OH 44012-1496
Phone
(440) 933-4486
Fax
(440) 930-4681
NPI assigned
Apr 12, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 9975 SC
General Practice Dentistry 1223G0001X 30.027160 OH Primary

Addresses

Primary practice location

33398 Walker Rd Ste a
Avon Lake, OH 44012-1496

Mailing address

33398 Walker Rd Ste a
Avon Lake, OH 44012-1496
Phone (440) 933-4486

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
9975SCMDClinical Social Worker
30.027160OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Daniel Mark Hostrander, DDS, PLLC PastSince Dec 13, 2022 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774310400000",
    "number": "1043890296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33398 WALKER RD STE A",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440121496",
            "telephone_number": "440-933-4486",
            "fax_number": "440-930-4681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33398 WALKER RD STE A",
            "city": "AVON LAKE",
            "state": "OH",
            "postal_code": "440121496",
            "telephone_number": "440-933-4486",
            "fax_number": "440-930-4681"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARGARET",
        "middle_name": "LUCRETIA",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-12",
        "last_updated": "2026-03-24",
        "certification_date": "2026-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9975",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.027160",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avon Lake, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.