Annelise Helen Sullivan, D.D.S., M.S.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

30.023192 Issued in OH

Practice address

8803 Brecksville Rd
Brecksville, OH 44141-1932

Phone

(440) 526-7506

Fax

(440) 526-7546

NPI assigned

Jan 18, 2012

Last updated

Jan 18, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1326844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326844800000",
    "number": "1700157195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8803 BRECKSVILLE RD",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441411932",
            "telephone_number": "440-526-7506",
            "fax_number": "440-526-7546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8803 BRECKSVILLE RD",
            "city": "BRECKSVILLE",
            "state": "OH",
            "postal_code": "441411932",
            "telephone_number": "440-526-7506",
            "fax_number": "440-526-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "ANNELISE",
        "middle_name": "HELEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-01-18",
        "last_updated": "2012-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "OH",
            "license": "30.023192",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Stover, R.N.
• Jessica Lynn Strzalka, RN
• Andie Stuart
• Suburban Physical Therapy, Inc
• Melanie Sudetic
• Susan Katherine Sullivan, RN
• Franklin Joseph Sweeney
• Jennifer M. Swihart, RPH
• Andrew Takacs
• Benjamin F Tancinco, MD

• Orthodontics and Dentofacial Orthopedics Dentistry in Brecksville, OH
• Providers in Brecksville, OH by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2012; 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.