Kevin Thomas Sullivan, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN.00204038 Issued in CO

Practice address

675 Snap Dragon Way Unit 250
Steamboat Springs, CO 80487-2141

Phone

(970) 457-4120

NPI assigned

Jun 13, 2019

Sex

Male

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

State licenses

Practice roles

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.

• Pine Grove Dental Arts

  • Dentist
  • Steamboat Springs, CO
  • NPI 1699916221
  NPD (past)
• Pine Grove Dental Associates

  • General Practice Dentistry
  • Steamboat Spring, CO
  • NPI 1346308608
  NPD (past)

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

{
    "created_epoch": "1560384000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687910400000",
    "number": "1750940615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22630 SNOWBIRD TRL",
            "city": "OAK CREEK",
            "state": "CO",
            "postal_code": "804678600",
            "telephone_number": "508-574-8090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 SNAP DRAGON WAY UNIT 250",
            "city": "STEAMBOAT SPRINGS",
            "state": "CO",
            "postal_code": "804872141",
            "telephone_number": "970-457-4120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SULLIVAN",
        "first_name": "KEVIN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-06-13",
        "last_updated": "2023-06-28",
        "certification_date": "2023-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "DEN.00204038",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alethea Stone
• Storm Mountain Orthopaedics, PC
• Laura Stout, RD
• Sierra Alexandra Stout, PT
• Victoria L Strohmeyer, RYT, MBA, ADS
• Kirsten Summers, RDN, CLC
• Sunshine Dentistry PC
• Sunshine Dentistry PLLC
• Symmetry Healing, LLC
• Tiffany Terry, D.C.

• General Practice Dentistry in Steamboat Springs, CO
• Providers in Steamboat Springs, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2023; 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.