TARA SULLIVAN, DDS PLLC (NPI# 1215295498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215295498 |
| Entity Type | Organization |
| Organization Name | TARA SULLIVAN, DDS PLLC |
| Other Organization Name | THE DENTAL SHOPPE |
| Practice Address |
1203 E Pine Street Seattle WA 98122 |
| Practice Telephone | 2068298432 |
| Mailing Telephone | 2068298432 |
| Enumeration Date | 2012-04-25 |
| Last Update Date | 2012-04-25 |
| Authorized Official Name | TARA MARIE SULLIVAN (OWNER) |
| Authorized Official Telephone | 2068298432 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
DE00010943 | WA | Dental Providers |
| Other Name | Type Code |
|---|---|
| THE DENTAL SHOPPE | Doing Business As Name - Organization |
| Street Address |
1203 E PINE STREET |
| City | SEATTLE |
| State | WA |
| Zip Code | 98122 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053938506 | Quality Counseling and Consultation Service LLC | Counselor | 1525 Harvard Ave #509, Seattle, WA 98122 | 2020-07-01 |
| 1912535626 | Cesar Andrade | Student in an Organized Health Care Education/Training Program | 550 16th Avenue #400, Seattle, WA 98122 | 2020-03-29 |
| 1366089666 | Peter Nguyen | Pharmacy Technician | 914 East Jefferson Street, Campion Hall, Seattle, WA 98122 | 2019-12-05 |
| 1356903140 | Jason Dandino | Specialist/Technologist | 550 14th Avenue, Seattle, WA 98122 | 2019-07-02 |
| 1962066415 | Seattle Colleges | Local Education Agency (LEA) | Mainstay At Seattle Central College, 1701 Broadway Ms Be3210, Seattle, WA 98122 | 2019-04-30 |
| 1538621412 | Mitchell R Ornelas | Student in an Organized Health Care Education/Training Program | Swedish Family Medicine Residency Cherry Hill; 550 16th, Avenue #400, Seattle, WA 98122 | 2019-04-01 |
| 1003374265 | Michael Russell | Surgery | 747 Broadway Heath Building 10th Floor, Seattle, WA 98122 | 2019-03-06 |
| 1639646821 | Maritza E Cajiao | Doula | 747 Broadway, Seattle, Seattle, WA 98122 | 2018-10-25 |
| 1336616762 | Suzanna M Lovin | Social Worker | 401 Broadway, 1st Floor, Seattle, WA 98122 | 2018-10-24 |
| 1184137770 | Walter Franklin Krengel Jr. | Orthopaedic Surgery | 2000 1st Ave Suite 2201, Seattle, WA 98122 | 2017-11-06 |
| Find all providers in zip 98122 | ||||
| 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 |
|---|---|---|---|---|
| 1730789082 | Kim & Cervantes-kim Dds Pllc | Dentist | 945 Elliott Ave W Ste 212, Seattle, WA 98119-3645 | 2020-10-27 |
| 1790383867 | Washington Dental Corporation, PC | Dentist | 620 1st Ave N, Seattle, WA 98109-4001 | 2020-10-12 |
| 1275140535 | Byeonguk Kang | Dentist | 1959 Ne Pacific St Rm B403, Seattle, WA 98195-0001 | 2020-09-29 |
| 1013524743 | David Park | Dentist | 810 3rd Ave Ste 200, Seattle, WA 98104-1614 | 2020-09-27 |
| 1073138558 | Mijin Choi | Dentist | 285 8th Ave N Apt 204, Seattle, WA 98109-5173 | 2020-06-10 |
| 1578020632 | Abu & Del Rosario, Pllc | Dentist | 1220 Howell St Ste 110, Seattle, WA 98101-1407 | 2019-02-25 |
| 1649755505 | William Lowrey | Dentist | 836 Ne 67th St Apt 712, Seattle, WA 98115-5882 | 2018-09-26 |
| 1215419809 | Gregory Arlen Maggass Jr. | Dentist | 4222 7th Ave Ne Apt 8, Seattle, WA 98105-6086 | 2018-08-30 |
| 1295214757 | Suzanne S Hall | Dentist | 515 N 138th St, Seattle, WA 98133-7420 | 2018-08-07 |
| 1871088195 | Hanbit Chi, Dds, Ps | Dentist | 1331 Harbor Ave Sw Ste 100, Seattle, WA 98116-1776 | 2018-06-28 |
| Find all providers in SEATTLE | ||||
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| 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.