Jerry E. Sullins, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS3056 Issued in TN

Legal business name

JERRY E. SULLINS, DDS

Practice address

104 Hazel Path
Suite 1
Hendersonville, TN 37075-3844

Phone

(615) 824-7220

Fax

(615) 824-9947

NPI assigned

Mar 24, 2008

Last updated

Mar 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daphne Potter

Title

Front Office Manager

Phone

(615) 824-7220

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Bradley J Greives, DDS

  • General Practice Dentistry
  • Hendersonville, TN
  • NPI 1013228915
  NPD (past)

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

{
    "created_epoch": "1206316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206316800000",
    "number": "1649442252",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 HAZEL PATH",
            "address_2": "SUITE 1",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370753844",
            "telephone_number": "615-824-7220",
            "fax_number": "615-824-9947"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 HAZEL PATH",
            "address_2": "SUITE 1",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370753844",
            "telephone_number": "615-824-7220",
            "fax_number": "615-824-9947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERRY E. SULLINS, DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-24",
        "last_updated": "2008-03-24",
        "status": "A",
        "authorized_official_last_name": "POTTER",
        "authorized_official_first_name": "DAPHNE",
        "authorized_official_title_or_position": "FRONT OFFICE MANAGER",
        "authorized_official_telephone_number": "615-824-7220"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "DS3056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jean-Max Jean-Pierre, DDS MDS
• Michelle Jeffrey
• Erin Jenkins, PA-C
• Jensen Medical, Inc
• Jensenlittle
• David George Jewett, M.D.
• Neenu Jithin
• Promise Joe
• Johnson I-Care, LLC
• Antionette Johnson

• General Practice Dentistry in Hendersonville, TN
• Providers in Hendersonville, TN by specialty
• General Practice Dentistry in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2008; 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.