NPIMap

Individual provider Active NPI

Daniel Peter Sullivan, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Warren, NJ
National Provider Identifier
1649376468
Registry record updated Nov 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
22DI02036700 Issued in NJ
Practice address
58 Mount Bethel Rd
Ste 202
Warren, NJ 07059-2654
Phone
(908) 222-7922
Fax
(908) 222-7923
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 22DI02036700 NJ Primary

Addresses

Primary practice location

58 Mount Bethel Rd
Ste 202
Warren, NJ 07059-2654

Mailing address

58 Mount Bethel Rd
Ste 202
Warren, NJ 07059-2654
Phone (908) 222-7922

Other names 1

  • Dr. Daniel Peter Sullivan Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170221002268 NJ Practitioner - Oral Surgery 5395063994 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
New York University College of Dentistry, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Warren Oral and Maxillofacial Surgery Associates, LLCGroup PAC ID 7315221264, 2 clinicians

Practice addresses (Care Compare)

58 Mount Bethel Rd
Suite 202
Warren, NJ 07059-2655
Phone (908) 222-7922

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
047368NYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Warren Oral & Maxillofacial Surgery Associates, LLC Oral and Maxillofacial Surgery CurrentSince Dec 14, 2016 Accepting new patients
Edison-Clark Oral Surgery Associates Oral and Maxillofacial Surgery PastSince Feb 4, 1992 Accepting new patients
Warren Oral & Maxillofacial Surgery Center, LLC Oral and Maxillofacial Surgery PastSince Dec 14, 2016 Accepting new patients
Primary Care Group LLC PastSince Aug 11, 2019 Accepting new patients

Locations

58 Mount Bethel Rd
Ste 202
Warren, NJ 07059
Phone (908) 222-7922

Interoperability endpoints

  • Direct secure messaging: dsullivan53753@epicdirect.rwjbh.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 26

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446508800000",
    "number": "1649376468",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "58 MOUNT BETHEL RD",
            "address_2": "STE 202",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070592654",
            "telephone_number": "908-222-7922",
            "fax_number": "908-222-7923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "58 MOUNT BETHEL RD",
            "address_2": "STE 202",
            "city": "WARREN",
            "state": "NJ",
            "postal_code": "070592654",
            "telephone_number": "908-222-7922",
            "fax_number": "908-222-7923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "DANIEL",
        "middle_name": "PETER",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2015-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "22DI02036700",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "DANIEL",
            "last_name": "SULLIVAN",
            "middle_name": "PETER",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Warren, NJ

Sources for this page

Verify at the official NPI Registry.