Marilee J Sullivan, RDH/EPDH

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

H0550 Issued in OR

Practice address

21186 Sayre Drive
Aurora, OR 97002

Phone

(503) 984-2860

NPI assigned

Nov 21, 2011

Last updated

Nov 21, 2011By the provider in NPPES

Sex

Female

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

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": "1321833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321833600000",
    "number": "1295002129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 34",
            "city": "AURORA",
            "state": "OR",
            "postal_code": "970020034",
            "telephone_number": "503-678-2860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21186 SAYRE DRIVE",
            "city": "AURORA",
            "state": "OR",
            "postal_code": "97002",
            "telephone_number": "503-984-2860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "MARILEE",
        "middle_name": "J",
        "credential": "RDH/EPDH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-11-21",
        "last_updated": "2011-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "OR",
            "license": "H0550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Joseph B. Young, D.M.D.

• Dental Hygienist in Aurora, OR
• Providers in Aurora, OR by specialty
• Dental Hygienist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2011; 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.