Active NPI
Sheldon Sullaway, DMD
- Dentist
- Danvers, MA
National Provider Identifier
1467812149
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DN9691
- Practice address
- 99 Village Post Rd
Danvers, MA 01923-2616 - Phone
- (978) 774-1583
- NPI assigned
- Feb 24, 2016
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | DN9691 | MA | Primary |
Addresses
Primary practice location
99 Village Post Rd
Danvers, MA 01923-2616
Mailing address
99 Village Post Rd
Danvers, MA 01923-2616
Phone (978) 774-1583
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN9691 | MA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1456272000000",
"number": "1467812149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "99 VILLAGE POST RD",
"city": "DANVERS",
"state": "MA",
"postal_code": "019232616",
"telephone_number": "978-774-1583"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "99 VILLAGE POST RD",
"city": "DANVERS",
"state": "MA",
"postal_code": "019232616",
"telephone_number": "978-774-1583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLAWAY",
"first_name": "SHELDON",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2016-02-24",
"last_updated": "2016-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MA",
"license": "DN9691",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Danvers, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.