DR. LAURA GRACE SULLIVAN (NPI# 1649409632) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649409632 |
| Entity Type | Individual |
| Full Name | DR. LAURA GRACE SULLIVAN |
| Other Name | DR. LAURA GRACE TUCKER |
| Credential | DMD |
| Practice Address |
1949 Cr 210 W Saint Johns FL 32259-2062 |
| Mailing Address |
1949 Cr 210 W Saint Johns FL 32259 |
| Practice Telephone | 9044024409 |
| Practice Fax Number | 9043428113 |
| Mailing Telephone | 9048084700 |
| Mailing Fax Number | 9043428113 |
| Enumeration Date | 2009-07-10 |
| Last Update Date | 2013-08-02 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | DN18660 | FL | Dental Providers |
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
DN18660 | FL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912531062 | Laura Sullivan | Nurse Practitioner | 2465 Route 97 Ste 10, Glenwood, MD 21738-9749 | 2020-02-27 |
| 1992292080 | Laura Anne Sullivan | Specialist | 5 Terrace Pl, Glen Cove, NY 11542-2427 | 2018-04-16 |
| 1164833232 | Laura Sullivan | Occupational Therapist | 30 Sheffield Rd, Wilton, NY 12831-1494 | 2014-05-12 |
| 1912337502 | Laura Sullivan | Physical Therapist | 1900 American Eagle Drive, Slinger, WI 53086-9043 | 2013-11-18 |
| 1558686063 | Laura Ann Sullivan | Social Worker | 60 Perseverance Way Fl 2, Hyannis, MA 02601-1843 | 2010-03-29 |
| 1083809818 | Laura E Sullivan | Pharmacist | 3303 Grand Oaks Ct, Pittsburg, KS 66762-8737 | 2007-09-14 |
| 1932266137 | Laura Sullivan | Marriage & Family Therapist | 18 S Indiana St, Mooresville, IN 46158-1648 | 2007-01-03 |
| 1902994841 | Laura Sullivan | Psychologist | Adult Admissions Unit, John Umstead Hospital, Butner, NC 27509 | 2006-10-10 |
| 1700892437 | Laura Sullivan | Internal Medicine | 7316 S. Settler Dr., Morrison, CO 80465 | 2006-08-01 |
| 1114904778 | Laura Marie Sullivan | Social Worker | 9 Carlito Rd, Santa Fe, NM 87508-8784 | 2005-12-26 |
| Street Address |
1949 CR 210 W |
| City | SAINT JOHNS |
| State | FL |
| Zip Code | 32259-2062 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659904571 | Ayla Rose Yarbrough | Chiropractor | 1620 County Road 210, St. Johns County, FL 32259 | 2020-02-19 |
| 1831731009 | Andrew Dacunha, Dmd, Pa | Dentist | 71 Doctors Village Drive, Suite 303, Saint Johns, FL 32259 | 2019-10-09 |
| 1801446257 | Mary Alice Taylor | Counselor | 213 Trapper Trace Ct., St. Johns, FL 32259 | 2019-09-18 |
| 1609425826 | Publix Super Markets, Inc. | Durable Medical Equipment & Medical Supplies | 155 Bartram Park Drive, Suite 100, St. Johns, FL 32259 | 2019-09-10 |
| 1518438936 | Yazji Pediatric Care | Pediatrics | 4125 Race Track Rd, Suite Number 104, Saint Johns, FL 32259 | 2018-12-11 |
| 1003328022 | Abundant Life Health Center LLC | Chiropractor | 254 Everest Lane, St. Johns, FL 32259 | 2017-10-31 |
| 1356863732 | Jennifer Eberhard | Nurse Practitioner | 335 Oxford Estates Way, Saint Johns, FL 32259 | 2017-07-07 |
| 1366986861 | Taylor Leard | Physician Assistant | 2001 County Rd 210, Suite 101, St. Johns, FL 32259 | 2016-12-19 |
| 1043760390 | Comfortable Care Dental Health Professionals, Pa | Dentist | 2532 Race Track Rd, Saint Johns, FL 32259 | 2016-10-11 |
| 1598114233 | Bright Smiles Pediatric Dentistry, Pllc | Dentist | 196 Everest Ln Unit 1, Saint Johns, FL 32259 | 2016-06-03 |
| Find all providers in zip 32259 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598114233 | Bright Smiles Pediatric Dentistry, Pllc | Dentist | 196 Everest Ln Unit 1, Saint Johns, FL 32259 | 2016-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073113296 | Pediatric Dental Center of Gardens Inc | Dentist | 18244 Nw 27th Ave, Miami Gardens, FL 33056-3501 | 2020-10-27 |
| 1205446598 | Harp Pediatric Dentistry | Dentist | 31067 Us Highway 19 N, Palm Harbor, FL 34684-4416 | 2020-08-03 |
| 1043829377 | Little Champions Pediatric Dentistry | Dentist | 1330 Sw 22nd St Ste 406, Miami, FL 33145-2945 | 2020-07-22 |
| 1710595509 | Bright Smiles Pediatric Dentistry Nassau LLC | Dentist | 960135 Gateway Blvd, Fernandina Beach, FL 32034-9120 | 2020-07-17 |
| 1578180097 | Juliana Grace Fitzgerald | Dentist | 7505 Grand Lely Dr Bldg 1, Naples, FL 34113-1753 | 2020-06-30 |
| 1861012569 | Toni-marie Small | Dentist | 12625 76th Rd N, West Palm Beach, FL 33412-2259 | 2020-04-22 |
| 1003446824 | Spring Hill Pediatric Dentistry, LLC | Dentist | 7140 Sagheer St., Brooksville, FL 34613 | 2020-01-21 |
| 1114573086 | Kids Dentist LLC | Dentist | 8058 W Mcnab Rd, North Lauderdale, FL 33068-4254 | 2019-08-15 |
| 1558915157 | Dentistry for Children of Florida, Pllc | Dentist | 3021 Airport Rd N Ste 203, Naples, FL 34105-3077 | 2019-07-31 |
| 1528620937 | Catherine Jane Graham | Dentist | 1395 Center Dr Rm D11-6, Gainesville, FL 32610-3006 | 2019-07-05 |
| Find all providers with the same taxonomy | ||||
| City | SAINT JOHNS |
| Zip Code | 32259 |
Please comment or provide details below to improve the information on DR. LAURA GRACE 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.