DR. ROGER BARRETT SULLIVAN SR. (NPI# 1740382001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740382001 |
| Entity Type | Individual |
| Full Name | DR. ROGER BARRETT SULLIVAN SR. |
| Credential | DDS |
| Practice Address |
13552 Wenwood Pkwy Dr Roger B Sullivan Fenton MI 48430-1160 |
| Mailing Address |
13552 Wenwood Pkwy Fenton MI 48430-1160 |
| Practice Telephone | 8106295695 |
| Practice Fax Number | 8106290968 |
| Mailing Telephone | 8106295695 |
| Mailing Fax Number | 8106290968 |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 6954 | MI | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669600425 | Roger Barrett Sullivan Jr. | Dentist | 449 N Grand St, Schoolcraft, MI 49087-9141 | 2009-06-30 |
| 1346534484 | Roger Patrick Sullivan | Family Medicine | 9228 Medical Plaza Dr, Dept Family Medicine, Charleston, SC 29406-9125 | 2011-06-07 |
| Street Address |
13552 WENWOOD PKWY DR ROGER B SULLIVAN |
| City | FENTON |
| State | MI |
| Zip Code | 48430-1160 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225647514 | Drs Mesh, P.C. | Dentist | 15555 Silver Parkway, Fenton, MI 48430 | 2020-07-23 |
| 1225515091 | Erica Anderson | Social Worker | 127 River St., Fenton, MI 48430 | 2018-07-25 |
| 1245767888 | Optimum Balance | Clinic/Center | 1537 N. Leroy Street, Suite D, Fenton, MI 48430 | 2017-05-14 |
| 1710411293 | Abdul Hassan | Thoracic Surgery (Cardiothoracic Vascular Surgery) | 11 Chateaux Du Lac, Fenton, MI 48430 | 2017-04-12 |
| 1366994410 | Intentional Wellbeing LLC | Psychologist | 1122 N. Leroy Rd, Suite A, Fenton, MI 48430 | 2016-10-25 |
| 1265801625 | Shawn Marie Gorkiewicz | Nurse Practitioner | 435 North Leroy, Fenton, MI 48430 | 2015-09-16 |
| 1972994226 | Carrie Hamilton | Physical Medicine & Rehabilitation | 102 N Adelaide St Ste B, Fenton, MI 48430 | 2015-02-09 |
| 1104222520 | Wellbridge of Fenton, LLC | Skilled Nursing Facility | 901 Pine Creek Drive, Fenton, MI 48430 | 2014-11-12 |
| 1225442759 | Joseph Matthew Leppek | Optometrist | 1425 N. Leroy St., Fenton, MI 48430 | 2014-06-12 |
| 1437569647 | Therapy Support Center LLC | Clinic/Center | 113 North River Street, Fenton, MI 48430 | 2014-04-28 |
| Find all providers in zip 48430 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053929778 | Travis Barrett | Dentist | 729 Winding Bluffs Dr, Fenton, MO 63026-5564 | 2020-07-20 |
| 1265926620 | Shea Aaron Wilson | Dentist | 750 Gravois Bluffs Blvd Ste C, Fenton, MO 63026-7720 | 2018-06-19 |
| 1083086466 | Jay F. Hauser, Dds, PC | Dentist | 750 Gravois Bluffs Blvd, Suite C, Fenton, MO 63026-7726 | 2015-10-26 |
| 1982092128 | Sarah Paxton Dds PC | Dentist | 17197 Silver Pkwy, Fenton, MI 48430-3426 | 2014-12-22 |
| 1386057032 | Andrew Kemlage | Dentist | 1576 Smizer Station Rd, Fenton, MO 63026-3290 | 2014-06-10 |
| 1629239447 | Michelle Ann Sgalia | Dentist | 1398 North Leroy Street, Fenton, MI 48430 | 2008-06-24 |
| 1679740567 | Joseph A. Blaes | Dentist | 1736 Gilsinn Ln, Fenton, MO 63026-2004 | 2008-05-11 |
| 1396953972 | Sarah Lynn Paxton | Dentist | 138 N Leroy St, Fenton, MI 48430-3803 | 2007-05-18 |
| 1609914019 | James Michael Rachor | Dentist | 1398 N Leroy St, Fenton, MI 48430 | 2007-02-01 |
| 1295805026 | Fda PC | Dentist | 1535 N Leroy, F, Fenton, MI 48430 | 2006-11-09 |
| Find all providers in FENTON | ||||
Please comment or provide details below to improve the information on DR. ROGER BARRETT SULLIVAN SR..
| 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.