Active NPI
William Kevin Sullivan, DMD
- Dentist
- Manchester, NH
National Provider Identifier
1659375384
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3221
- Practice address
- 100 McGregor St
E-542
Manchester, NH 03102-3730 - Phone
- (603) 663-6226
- Fax
- (603) 663-7800
- NPI assigned
- Jun 10, 2005
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 3221 | NH | Primary |
Addresses
Primary practice location
100 McGregor St
E-542
Manchester, NH 03102-3730
Mailing address
100 McGregor St
E-542
Manchester, NH 03102-3730
Phone (603) 663-6226
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30301692 | Medicaid | NH |
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 |
|---|---|---|---|
| 3221 | NH | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118361600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187308800000",
"number": "1659375384",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 MCGREGOR ST",
"address_2": "E-542",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031023730",
"telephone_number": "603-663-6226",
"fax_number": "603-663-7800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 MCGREGOR ST",
"address_2": "E-542",
"city": "MANCHESTER",
"state": "NH",
"postal_code": "031023730",
"telephone_number": "603-663-6226",
"fax_number": "603-663-7800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "WILLIAM",
"middle_name": "KEVIN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-10",
"last_updated": "2007-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NH",
"license": "3221",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30301692",
"state": "NH"
}
],
"endpoints": [],
"other_names": []
}Other providers in Manchester, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.