Tara Sullivan, DDS PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00010943 Issued in WA

Legal business name

TARA SULLIVAN, DDS PLLC

Doing business as

THE DENTAL SHOPPE

Practice address

1203 E Pine Street
Seattle, WA 98122

Phone

(206) 829-8432

NPI assigned

Apr 25, 2012

Organization subpart

No

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

Authorized official

Name

Tara Marie Sullivan, DDSNPI 1023202363

Title

Owner

Phone

(206) 829-8432

Specialties & licenses 1

Addresses

Other names 1

• THE DENTAL SHOPPE Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Tara Marie Sullivan, D.D.S.

  • Dentist
  • Seattle, WA
  • NPI 1023202363
  NPD (past) Authorized official

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

{
    "created_epoch": "1335312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335312000000",
    "number": "1215295498",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1203 E PINE STREET",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98122",
            "telephone_number": "206-829-8432"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 E PINE STREET",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98122",
            "telephone_number": "206-829-8432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TARA SULLIVAN, DDS PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-25",
        "last_updated": "2012-04-25",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "TARA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "206-829-8432",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00010943",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "THE DENTAL SHOPPE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christy E. Tapp, RC
• Hayley Rae Tapp, LMHC
• Jordan William Tappero, M.D., M.P.H.
• Stephen J Tapscott
• Tara Murphy Therapy
• Erica Shantha Tarabadkar, MD
• Julie K Taraday, MD
• William Stanton Taraday I, DDS
• Jessica Tarantino, PSY.D.
• Joseph Tarascavage, PT, DPT

• General Practice Dentistry in Seattle, WA
• Providers in Seattle, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2012; 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.