Stephen E. Sullivan III, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2841-94 Issued in MS

Practice address

160 Cracker Barrel Dr
Batesville, MS 38606-3031

Phone

(662) 563-7821

NPI assigned

Sep 25, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Batesville Premier Dental PLLC

  • Dental Clinic/Center
  • Batesville, MS
  • NPI 1033095054
  NPD Authorized official

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083714125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1200",
            "city": "BATESVILLE",
            "state": "MS",
            "postal_code": "386061200",
            "telephone_number": "662-563-7821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 CRACKER BARREL DR",
            "city": "BATESVILLE",
            "state": "MS",
            "postal_code": "386063031",
            "telephone_number": "662-563-7821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "STEPHEN",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "2841-94",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Strategic Solutions-Panola Medical Center LLC (Panola Medical Center)
• Strategic Solutions-Panola Medical Center LLC (Panola Family and Specialty Clinic)
• Strategic Solutions-Panola Medical Center LLC (Panola Women's and Children's Clinic)
• Shaniqua Strong, RN
• Samuel Clifton Sullivan, DMD
• Sullivan's Drug Store,Inc
• Jennifer J Sullivant, R.PH.
• Sunrise Medical Group PLLC
• Superior MRI Services, Inc.
• Surrender Therapy LLC

• General Practice Dentistry in Batesville, MS
• Providers in Batesville, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.