Active NPI
Jeanne F Sullivan, RDH
- Dental Hygienist
- Fairhaven, MA
National Provider Identifier
1972848919
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH10483
- Practice address
- 97 Church St
Fairhaven, MA 02719-3723 - Phone
- (508) 951-6403
- NPI assigned
- Dec 3, 2012
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH10483 | MA | Primary |
Addresses
Primary practice location
97 Church St
Fairhaven, MA 02719-3723
Mailing address
97 Church St
Fairhaven, MA 02719-3723
Phone (508) 951-6403
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 |
|---|---|---|---|
| DH10483 | MA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1354492800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1354492800000",
"number": "1972848919",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "97 CHURCH ST",
"city": "FAIRHAVEN",
"state": "MA",
"postal_code": "027193723",
"telephone_number": "508-951-6403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "97 CHURCH ST",
"city": "FAIRHAVEN",
"state": "MA",
"postal_code": "027193723",
"telephone_number": "508-951-6403"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SULLIVAN",
"first_name": "JEANNE",
"middle_name": "F",
"name_prefix": "Ms.",
"credential": "RDH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-12-03",
"last_updated": "2012-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "MA",
"license": "DH10483",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairhaven, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.