Laura Ellen Sullivan, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19254 Issued in MA

Practice address

56 Walpole St
Norwood, MA 02062-3316

Phone

(781) 769-1371

Fax

(781) 769-4876

NPI assigned

Jun 25, 2007

Sex

Female

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 MA

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

Practice roles

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.

• Laura E. Sullivan, D.M.D.,P.C.

  • Dental Clinic/Center
  • Norwood, MA
  • NPI 1780719849
  NPD (past) Authorized official

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

{
    "created_epoch": "1182729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215133558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 WALPOLE ST",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020623316",
            "telephone_number": "781-769-1371",
            "fax_number": "781-769-4876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 WALPOLE ST",
            "city": "NORWOOD",
            "state": "MA",
            "postal_code": "020623316",
            "telephone_number": "781-769-1371",
            "fax_number": "781-769-4876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "LAURA",
        "middle_name": "ELLEN",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "19254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Success Staffing Agency LLC
• Amy Louise Sulkala, LICSW
• Bruce E. Sullivan, D.M.D.
• Erin Sullivan, LMHC
• Kristen Sullivan
• Matthew Francis Sullivan, MD
• Naima Bigby Sullivan, MS, RD, LDN
• Rory Sullivan, MA
• Samantha Sullivan
• Thomas Patrick Sullivan, LMHC

• General Practice Dentistry in Norwood, MA
• Providers in Norwood, MA by specialty
• General Practice Dentistry in Massachusetts

• 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.