Dennis P. Sullivan, M.D., Inc.

Primary specialty

SpecialistTaxonomy code 174400000X

License

35-037690 Issued in OH

Legal business name

DENNIS P. SULLIVAN, M.D., INC.

Practice address

30 W. McCreight Ave Ste 103
Springfield, OH 45504

Phone

(937) 399-8921

Fax

(937) 629-9248

NPI assigned

Sep 25, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Dennis Patrick Sullivan, M.D.

Title

Physician

Phone

(937) 399-8921

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1264982400000",
    "number": "1477653897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 W. MCCREIGHT AVE STE 103",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "45504",
            "telephone_number": "937-399-8921",
            "fax_number": "937-629-9248"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 W. MCCREIGHT AVE STE 103",
            "city": "SPRINGFIELD",
            "state": "OH",
            "postal_code": "45504",
            "telephone_number": "937-399-8921",
            "fax_number": "937-629-9248"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DENNIS P. SULLIVAN, M.D., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2010-02-01",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_middle_name": "PATRICK",
        "authorized_official_title_or_position": "PHYSICIAN",
        "authorized_official_telephone_number": "937-399-8921",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OH",
            "license": "35-037690",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2945273",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "SU4262411",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Marie Delaet
• Tyler B Delong, QMHS
• Gerda Delva Brize
• Joseph Gerard Demeter, MD
• Tina Dennin, RN
• Nadine K Dennison
• Mischel Depp
• Derr Leasing Co., LLC
• Lora Lee Derr, LSW
• Miah Desantis

• Specialist in Springfield, OH
• Providers in Springfield, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; 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.