Terence Kevin Sullivan, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2764 Issued in LA

Practice address

206 Highland Park PLZ
Covington, LA 70433-7129

Phone

(985) 892-3310

Fax

(985) 892-2578

NPI assigned

Apr 18, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1093931057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 HIGHLAND PARK PLZ",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337129",
            "telephone_number": "985-892-3310",
            "fax_number": "985-892-2578"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 HIGHLAND PARK PLZ",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337129",
            "telephone_number": "985-892-3310",
            "fax_number": "985-892-2578"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "TERENCE",
        "middle_name": "KEVIN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "LA",
            "license": "2764",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1827649",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alberto Suarez, M.D.
• Sullivan Speech and Feeding LLC
• Kassi McLain Sullivan, SLP
• Michael A Sullivan, MD
• Skye Sullivan
• Summit Surgery Center, LLC
• Sunny Days Behavioral Therapy
• Surgical Eye Associates
• Surgical Specialists of Louisiana
• Lisa Surrency, LPC

• General Practice Dentistry in Covington, LA
• Providers in Covington, LA by specialty
• General Practice Dentistry in Louisiana

• 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.
• 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.