DR. ELLEN J SULLIVAN (NPI# 1598759789) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598759789 |
| Entity Type | Individual |
| Full Name | DR. ELLEN J SULLIVAN |
| Credential | DDS |
| Practice Address |
21414 Spencer Ave Queens Village NY 11427-1821 |
| Practice Telephone | 7184681812 |
| Practice Fax Number | 7184681815 |
| Mailing Telephone | 7184681812 |
| Mailing Fax Number | 7184681815 |
| Enumeration Date | 2005-09-02 |
| Last Update Date | 2007-07-08 |
| NPI Deactivation Date | 03/24/2006 |
| NPI Reactivation Date | 2006-04-12 |
| Gender Code | F |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
036823 | NY | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164991204 | Ellen Maura Sullivan | Counselor | 39 Stagecoach Rd, Hingham, MA 02043-4837 | 2018-11-19 |
| 1588994479 | Ellen Watters Sullivan | Social Worker | 1683 Parker Rd, Newport, VT 05855-9439 | 2009-12-28 |
| 1962728758 | Ellen Marie Sullivan | Counselor | 3440 Airway Dr, Suite E, Santa Rosa, CA 95403-2065 | 2010-04-19 |
| 1770729436 | Ellen Bristol Sullivan | Occupational Therapist | 100 Erdman Way, Lipton Center Early Intervention, Leominster, MA 01453-1804 | 2008-12-31 |
| 1972681567 | Ellen L. Sullivan | Internal Medicine | 1150 Veterans Blvd, Redwood City, CA 94063-2037 | 2006-11-01 |
| 1245320720 | Ellen Sullivan | Nurse Practitioner | 4301 W Markham St # 783, Little Rock, AR 72205-7101 | 2006-10-13 |
| 1861459760 | Ellen J Sullivan | Social Worker | 10 Tower Dr, Dean Medical Center, Sun Prairie, WI 53590-1239 | 2006-04-26 |
| Street Address |
21414 SPENCER AVE |
| City | QUEENS VILLAGE |
| State | NY |
| Zip Code | 11427-1821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255970984 | Hcode LLC | Case Manager/Care Coordinator | 212-29 Hillside Avenue, 6ew, Queens Village, NY 11427 | 2019-12-28 |
| 1659929735 | Adult Choice Np In Adult Heath Pllc | Clinic/Center | 21440 Hillside Ave, Queens, NY 11427 | 2019-08-31 |
| 1063079614 | Caitlin Knapp | Social Worker | Queens Village Jamaica Wellness and Recovery Center, 80-45 Winchester Boulevard (building 73), Queens Village, NY 11427 | 2019-05-20 |
| 1336648120 | Veronica Belinda Simpson V | Licensed Practical Nurse | 79-25 Wichester Blvd, Queens Village, NY 11427 | 2018-02-07 |
| 1427557404 | Frank Oriakhi | Licensed Practical Nurse | 79-25 Winchester Blv, Queens Village, NY 11427 | 2018-02-06 |
| 1376042333 | Mariamma C Oommen | Registered Nurse | 79 25 Winchester Blvd, Queens Village, NY 11427 | 2018-02-06 |
| 1861991838 | Claudette Erica Layne | Registered Nurse | 80-45 Winchester Blvd, Queens Village, NY 11427 | 2018-02-06 |
| 1194224253 | Annamma James I | Registered Nurse | 7925 Winchestetr Blvd, Winchester Bld, Queens, NY 11427 | 2018-02-05 |
| 1740798396 | Michael Mccain | Respite Care | 80-09 Winchester Blvd, Queens Village, NY 11427 | 2018-01-17 |
| 1831600121 | Marcia Maureen Higgins | Registered Nurse | 209-04 Hillside Avenue, Queens Village, NY 11427 | 2017-10-13 |
| Find all providers in zip 11427 | ||||
| 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 |
|---|---|---|---|---|
| 1750777082 | Blaise Anthony Guzzardo | Dentist | 94-71 217th St., Queens Village, NY 11428 | 2015-04-14 |
| 1083991822 | Queens Modern Dental | Dentist | 21820 Hempstead Ave, Suite 2, Queens Village, NY 11429-1235 | 2011-11-08 |
| 1568796746 | Amrita Persaud | Dentist | 8034 222nd St, Queens Village, NY 11427 | 2009-09-22 |
| 1194926287 | Glenn Kevin Rochlen | Dentist | 11206 Springfield Blvd, Queens Village, NY 11429-2650 | 2007-05-29 |
| 1710016175 | Jennifer F John-borde | Dentist | 9050 Francis Lewis Blvd, Queens Village, NY 11428-1069 | 2007-03-03 |
| 1700911682 | First Alert Dental Care, P.C. | Dentist | 21854 99th Ave, Queens Village, NY 11429-1206 | 2007-02-22 |
| 1922151331 | Schrier Dental Associates | Dentist | 20601 Jamaica Ave, Queens Village, NY 11428-1542 | 2007-01-19 |
| 1518049972 | Robert Louis Hamilton | Dentist | 8801 208th St, Queens Village, NY 11427-2258 | 2006-10-19 |
| 1740384874 | Blaise Guzzardo Dds PC | Dentist | 94-71 217th St, Queens Village, NY 11428 | 2006-09-11 |
| 1366568818 | Joseph Y Alerte | Dentist | 21854 99th Ave, Queens Village, NY 11429-1206 | 2007-03-22 |
| Find all providers in QUEENS VILLAGE | ||||
| City | QUEENS VILLAGE |
| Zip Code | 11427 |
Please comment or provide details below to improve the information on DR. ELLEN J 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.