Cort Patrick Sullivan

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

105643 Issued in CO

Practice address

6785 W 38TH Ave
Wheat Ridge, CO 80033

Phone

(303) 425-5903

NPI assigned

Mar 2, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1275661886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6785 W 38TH AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "80033",
            "telephone_number": "303-425-5903",
            "fax_number": "303-425-6227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6785 W 38TH AVE",
            "city": "WHEAT RIDGE",
            "state": "CO",
            "postal_code": "80033",
            "telephone_number": "303-425-5903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "CORT",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "105643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "133046",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah M Stuart, CRNA
• Adele L Stultz
• Breanne Styes
• Maryann Sudmeier, NP
• Lauryn Rose Sulley, NP
• Kyle Sullivan, MD
• Lauren Elizabeth Sullivan, LCSW
• Sara Sullivan
• Summit Radiation Oncology,P.C.
• Sunstar Psychiatry Services PLLC

• General Practice Dentistry in Wheat Ridge, CO
• Providers in Wheat Ridge, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.

Verify at the official NPI Registry.