Active NPI
Joseph E. Sullivan, D.M.D.
- Dentist
- Moorestown, NJ
National Provider Identifier
1063439636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 22DI01537702
- Practice address
- 285 S Church St
Suite 8
Moorestown, NJ 08057-2773 - Phone
- (856) 235-0449
- Fax
- (856) 235-6988
- NPI assigned
- Jul 17, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | DI015377-01 | NJ | |
| Dentist | 122300000X | 22DI01537702 | NJ | Primary |
Addresses
Primary practice location
285 S Church St
Suite 8
Moorestown, NJ 08057-2773
Mailing address
285 S Church St
Suite 8
Moorestown, NJ 08057-2773
Phone (856) 235-0449
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Oct 15, 2018 through Oct 15, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22DI01537702 | NJ | MD | Dentist |
| DI015377-01 | NJ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1447804800000",
"number": "1063439636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "285 S CHURCH ST",
"address_2": "SUITE 8",
"city": "MOORESTOWN",
"state": "NJ",
"postal_code": "080572773",
"telephone_number": "856-235-0449",
"fax_number": "856-235-6988"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "285 S CHURCH ST",
"address_2": "SUITE 8",
"city": "MOORESTOWN",
"state": "NJ",
"postal_code": "080572773",
"telephone_number": "856-235-0449",
"fax_number": "856-235-6988"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "JOSEPH",
"middle_name": "E.",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-17",
"last_updated": "2015-11-18",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "DI015377-01",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "22DI01537702",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moorestown, NJ
- Daniel K. Stringer
- Strive Physical Therapy and Sports Rehabilitation, LLC
- Strive Physical Therapy and Sports Rehabilitation, LLC
- Strive Physical Therapy Specialists LLC
- Strive Physical Therapy Specialists LLC
- Baylee Summers, PA
- Summit Spinal Care LLC
- Jay Sussman, M.D.
- Christina Swentowsky, PTA
- Laura J Switaj, PA-C
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2015; 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; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.