Active NPI
Gabriel Paul Sullivan, DDS
- Dentist
- Union City, TN
National Provider Identifier
1235223017
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS8584
- Practice address
- 1007 E Reelfoot Ave
Union City, TN 38261 - Phone
- (731) 885-2277
- Fax
- (731) 885-8852
- NPI assigned
- Oct 3, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS8584 | TN | Primary |
Addresses
Primary practice location
1007 E Reelfoot Ave
Union City, TN 38261
Mailing address
475 N Old Troy Rd
Troy, TN 38260
Phone (731) 536-5210
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS8584 | TN | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Gabe Sullivan DDS PLC | Dentist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Dentist
- Union City, TN
- NPI 1003900887
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235223017",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "475 N OLD TROY RD",
"city": "TROY",
"state": "TN",
"postal_code": "38260",
"telephone_number": "731-536-5210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1007 E REELFOOT AVE",
"city": "UNION CITY",
"state": "TN",
"postal_code": "38261",
"telephone_number": "731-885-2277",
"fax_number": "731-885-8852"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "GABRIEL",
"middle_name": "PAUL",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TN",
"license": "DS8584",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Union City, TN
Sources for this page
- 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.