John V. Sullivant, DDS,PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

AR2788 Issued in AR

Practice address

727 N Cardinal Dr
Mountain Home, AR 72653-3253

Phone

(870) 425-4242

Fax

(870) 425-4243

NPI assigned

Aug 10, 2006

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

Medicare fee-for-service enrollment

Enrolled in AR

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

Credentials

Physician Assistant

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.

• Dr. John V. Sullivant, D.D.S. P.a.

  • General Practice Dentistry
  • Mountain Home, AR
  • NPI 1982865986
  NPD (past) Authorized official

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255342028",
    "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",
            "fax_number": "870-425-4243"
        },
        {
            "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",
            "fax_number": "870-425-4243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVANT",
        "first_name": "JOHN",
        "middle_name": "V.",
        "name_prefix": "Dr.",
        "credential": "DDS,PA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-10",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "AR2788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Strout
• Donna Stuecken, LCSW
• Kora Klaire Stuffelbeam
• Ashley Sturdefant
• Pamelia Sullins
• Seth Sullivant, DDS
• Shelby Jane Summers
• Matthew Sutton, LPC-S, LPE-I
• Daniel A Swoyer, M.D.
• Sycamore Springs Senior Living, LLC

• General Practice Dentistry in Mountain Home, AR
• Providers in Mountain Home, AR by specialty
• General Practice Dentistry in Arkansas

• 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.