Active NPI
Emily Sullivan
- Endodontics
- West Hartford, CT
National Provider Identifier
1376167213
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- 13815
- Practice address
- 928 Farmington Ave
West Hartford, CT 06107-2227 - Phone
- (860) 233-2322
- NPI assigned
- Jun 6, 2020
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Endodontics | 1223E0200X | 13815 | CT | Primary |
Addresses
Primary practice location
928 Farmington Ave
West Hartford, CT 06107-2227
Mailing address
928 Farmington Ave
West Hartford, CT 06107-2227
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200819001836 | MA | Order and Referring Only - Other (Non-Physician) | 0345666475 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1692576000000",
"number": "1376167213",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "928 FARMINGTON AVE",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061072227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "928 FARMINGTON AVE",
"city": "WEST HARTFORD",
"state": "CT",
"postal_code": "061072227",
"telephone_number": "860-233-2322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "EMILY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-06",
"last_updated": "2023-08-21",
"certification_date": "2023-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "CT",
"license": "13815",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Hartford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.