Individual provider Active NPI

Seth Sullivant, DDS

  • General Practice Dentistry
  • Mountain Home, AR
National Provider Identifier
1255066858
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
4622 Issued in AR
Practice address
727 N Cardinal Dr
Mountain Home, AR 72653-3253
Phone
(870) 425-4242
NPI assigned
Jul 19, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4622 AR Primary

Addresses

Primary practice location

727 N Cardinal Dr
Mountain Home, AR 72653-3253

Mailing address

727 N Cardinal Dr
Mountain Home, AR 72653-3253
Phone (870) 425-4242

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

LicenseStateTypeSpecialty
4622ARMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Dr. John V. Sullivant, D.D.S. P.a. General Practice PastSince Jul 24, 2022 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1658188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1255066858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "727 N CARDINAL DR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533253",
            "telephone_number": "870-425-4242"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "727 N CARDINAL DR",
            "city": "MOUNTAIN HOME",
            "state": "AR",
            "postal_code": "726533253",
            "telephone_number": "870-425-4242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVANT",
        "first_name": "SETH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-19",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "4622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mountain Home, AR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; 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.