DR. SCOTT LOUIS SULLIVAN (NPI# 1063612844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063612844 |
| Entity Type | Individual |
| Full Name | DR. SCOTT LOUIS SULLIVAN |
| Credential | DDS |
| Practice Address |
76 Doctors Park Dr. Santa Rosa CA 95405-6615 |
| Mailing Address |
76 Doctors Park Dr. Santa Rosa CA 95405 |
| Practice Telephone | 7075466367 |
| Practice Fax Number | 7075427829 |
| Mailing Telephone | 7075466367 |
| Mailing Fax Number | 7075427829 |
| Enumeration Date | 2007-07-20 |
| Last Update Date | 2007-07-20 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
44095 | CA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265950737 | Scott Jeffrey Sullivan | Dentist | 3516 S 47th St Ste 104, Tacoma, WA 98409-4427 | 2017-09-06 |
| 1477070522 | Scott Sullivan | Physical Therapist | 5320 Mark Dabling Blvd # 100, Colorado Springs, CO 80918-3839 | 2017-08-29 |
| 1154344000 | Scott Keith Sullivan Jr. | Surgery | 1717 Saint Charles Ave, New Orleans, LA 70130-5223 | 2006-07-25 |
| 1972134567 | Scott R Sullivan | Student in an Organized Health Care Education/Training Program | 5200 Harry Hines Blvd, Dallas, TX 75235-7709 | 2020-02-01 |
| 1770056608 | Scott Lamar Sullivan | Counselor | 7000b S Center Dr, Clearlake, CA 95422-8131 | 2019-01-03 |
| 1386143899 | Scott Sullivan | Counselor | 4455 Ne Highway 20, Corvallis, OR 97330-9695 | 2018-02-10 |
| 1689100471 | Scott Sullivan | Student in an Organized Health Care Education/Training Program | 2390 W Congress St, Lafayette, LA 70506-4205 | 2017-05-11 |
| 1932467123 | Scott Sullivan | Student in an Organized Health Care Education/Training Program | 9040 Fitzsimmons Dr, Joint Base Lewis Mcchord, WA 98431-1000 | 2012-04-25 |
| 1033496179 | Scott Patric Sullivan | Specialist/Technologist | 205 S Main St, Suite C, Longmont, CO 80501-1716 | 2011-11-03 |
| 1750440004 | Scott G Sullivan | Physician Assistant | 301 Andrews Avenue, (lyster Army Health Clinic), Fort Rucker, AL 36362-5000 | 2006-12-06 |
| Street Address |
76 DOCTORS PARK DR. |
| City | SANTA ROSA |
| State | CA |
| Zip Code | 95405-6615 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1083230486 | Lizett Camacho | Counselor | 145o Neotomas Avenue Suite 200, Santa Rosa, CA 95405 | 2020-06-22 |
| 1346768918 | Ingrid Tsong | Student in an Organized Health Care Education/Training Program | 3447 Summerfield Road, Santa Rosa, CA 95405 | 2017-09-05 |
| 1275051898 | Jessica Peters Malmberg | Student in an Organized Health Care Education/Training Program | 2447 Summerfield Rd, Santa Rosa, CA 95405 | 2017-09-04 |
| 1306246772 | Kirsten Eckert | Advanced Practice Midwife | 500 Doyle Park Dr Suite 103, Santa Rosa, CA 95405 | 2014-09-03 |
| 1982034294 | Mohammad Reza Saeidi | Dentist | 1820 Sonoma Ave Ste 90a, Santa Rosa, CA 95405 | 2013-11-22 |
| 1851631642 | Debi M. Emmons | Marriage & Family Therapist | 2447 Summerfield Dr, Social Advocates for Youth, Santa Rosa, CA 95405 | 2013-02-15 |
| 1841549979 | Karie Louise Klim | Marriage & Family Therapist | 182 Farmers Ln Ste 204, Santa Rosa, CA 95405 | 2012-09-05 |
| 1427314400 | Rachel E. Page | Counselor | 2447 Summerfield Rd., Santa Rosa, CA 95405 | 2012-04-04 |
| 1689991572 | Center for Integral Healing Inc. | Community Health Worker | 182 Farmers Lane, #203, Santa Rosa, CA 95405 | 2010-04-30 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| Find all providers in zip 95405 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194369942 | M.s. Salek Dds, A Dental Corporation | Dentist | 2448 Guerneville Rd Ste 1000, Santa Rosa, CA 95403-7226 | 2019-11-05 |
| 1346806791 | Scott C. Bonin D.d.s. A Professional Denal Corporation | Dentist | 1260 N Dutton Ave Ste 290, Santa Rosa, CA 95401-7159 | 2019-05-11 |
| 1285035527 | Jeffers Dentistry Partnership | Dentist | 1820 Sonoma Ave Ste 42, Santa Rosa, CA 95405-6617 | 2014-09-05 |
| 1447699517 | Natalia Camacho-worms | Dentist | 1300 N. Dutton Ave, Santa Rosa, CA 95401 | 2013-06-21 |
| 1205170065 | Yunfei Fan Dds, A Professional Corporation | Dentist | 1420 Guerneville Rd Ste 5, Santa Rosa, CA 95403-4124 | 2012-11-19 |
| 1811231947 | Tingjen Ji | Dentist | 170 Farmers Ln Ste 1, Santa Rosa, CA 95405-4750 | 2012-11-15 |
| 1114295854 | James Klim | Dentist | 2755 Mendocino Ave, Suite 204, Santa Rosa, CA 95403-2827 | 2011-12-08 |
| 1588997647 | Kai Morgan | Dentist | 1144 Suite 116 Soonoma Ave, Santa Rosa, CA 95405 | 2009-09-08 |
| 1700029303 | Richard Anderson Dds | Dentist | 90 Doctors Park Drive, Santa Rosa, CA 95405-9998 | 2009-04-13 |
| 1356506596 | Kenneth James Bauer | Dentist | 55 Mission Cir Ste 107, Santa Rosa, CA 95409-5372 | 2008-07-28 |
| Find all providers in SANTA ROSA | ||||
| City | SANTA ROSA |
| Zip Code | 95405 |
Please comment or provide details below to improve the information on DR. SCOTT LOUIS SULLIVAN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.