DR. DAVID JOSEPH SULLIVAN (NPI# 1952632507) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1952632507 |
Entity Type | Individual |
Full Name | DR. DAVID JOSEPH SULLIVAN |
Credential | DDS, MSD |
Practice Address |
413 Nw Larch Ave Suite 201 Redmond OR 97756-1361 |
Mailing Address |
Po Box 2326 Bend OR 97709-2326 |
Practice Telephone | 5413162024 |
Practice Fax Number | 5415042124 |
Mailing Telephone | 5413162024 |
Mailing Fax Number | 5415042124 |
Enumeration Date | 2010-01-21 |
Last Update Date | 2010-01-21 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
D9384 | OR | Dental Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1669966966 | David Lee Sullivan Jr. | Case Manager/Care Coordinator | 513 Cannons Ln, Louisville, KY 40207-3645 | 2018-06-20 |
1154856987 | David Sullivan | Massage Therapist | 100 N Grape St Apt 303, Medford, OR 97501-3151 | 2017-04-30 |
1053733253 | David Sullivan | Contractor | 2823 Glover Carlton Rd, Perry, FL 32348-7640 | 2014-01-08 |
1023359312 | David Sullivan | Dentist | 5833 Phyliss Ln, Mint Hill, NC 28227-9031 | 2013-03-11 |
1952550402 | David Sullivan | Counselor | 2955 Valmont Rd Ste 110, Boulder, CO 80301-1360 | 2008-09-09 |
1558573956 | David E Sullivan | Social Worker | 704 Marketview Ct, Fayetteville, NC 28301-4868 | 2007-05-06 |
1467670026 | David Dell Sullivan | Physical Therapist | 499 Casey Way, Grand Junction, CO 81504-6281 | 2007-04-20 |
1578692760 | David Matthew Sullivan | Chiropractor | 104 Biddle Ave, Suite G, Harrison, OH 45030-2528 | 2007-03-05 |
1073648671 | David Joseph Sullivan | Optometrist | 276 S Hollywood Blvd, Steubenville, OH 43952-2422 | 2007-02-22 |
1033276837 | David Michael Sullivan | Dentist | 5177 N Bend Rd, Cincinnati, OH 45211-1900 | 2007-01-02 |
Street Address |
413 NW LARCH AVE SUITE 201 |
City | REDMOND |
State | OR |
Zip Code | 97756-1361 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1013992072 | Karen Jean Walz | Physical Therapist | 413 Nw Larch Ave, Suite 102, Redmond, OR 97756-1361 | 2005-12-13 |
1497104145 | Emily Dutton | Physical Therapist | 413 Nw Larch Ave, Suite 102, Redmond, OR 97756-1396 | 2016-06-03 |
1912304528 | Burrus Dentistry PC | Dentist | 413 Nw Larch Ave, Suite 201, Redmond, OR 97756-1361 | 2014-11-25 |
1770919730 | Stephanie Michelle O'neill | Dental Hygienist | 413 Nw Larch Ave, Suite 201, Redmond, OR 97756-1361 | 2013-09-23 |
1881986859 | David Mosher Burrus | Dentist | 413 Nw Larch Ave, Suite 201, Redmond, OR 97756-1361 | 2011-05-10 |
1922315043 | Therapeutic Associates, Inc | Occupational Therapist | 413 Nw Larch Ave, Suite 102, Redmond, OR 97756-1361 | 2010-09-10 |
1487960621 | Pacific Medical, Inc. | Durable Medical Equipment & Medical Supplies | 413 Nw Larch Ave, Ste 103, Redmond, OR 97756-1361 | 2010-08-25 |
1649583428 | Elise Burrus | Dentist | 413 Nw Larch Ave, Suite 201, Redmond, OR 97756-1361 | 2010-07-21 |
1073833448 | Debbie Rief Fnp LLC | Nurse Practitioner | 413 Nw Larch Ave, #203, Redmond, OR 97756-1361 | 2010-06-08 |
1033313697 | Amy J Houchens | Physical Therapist | 413 Nw Larch Ave, Suite 102, Redmond, OR 97756-1361 | 2007-06-14 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1679083349 | Vicki Rae Morris | Foster Care Agency | 3585 Sw 35th St., Redmond, OR 97756 | 2017-10-06 |
1275066417 | Norco, Inc | Durable Medical Equipment & Medical Supplies | 655 Nw Jackpine Ave, Redmond, OR 97756 | 2017-04-05 |
1750778015 | Kelly Gobler | Occupational Therapy Assistant | 3000 Sw 32nd Street, The Heights Assisted Living, Redmond, OR 97756 | 2015-04-23 |
1912303934 | Andrea Adams | Pharmacist | 944 Sw Veterans Way, Redmond, OR 97756 | 2014-11-18 |
1649670365 | Advantage Dental Clinics LLC | Dentist | 442 Sw Umatilla Ave., Suite 200, Redmond, OR 97756 | 2014-08-29 |
1760891832 | Elizabeth Mae Smith | Counselor | 2659 Sw 4th St Ste 102, Redmond, OR 97756 | 2014-08-04 |
1700296837 | Heather A Ahlf | Physician Assistant | 1245 Nw Canal Blvd, Redmond, OR 97756 | 2014-04-29 |
1306289277 | Asa Racquel Aramburo | Social Worker | 203 Sw 8th St., Redmond, OR 97756 | 2013-04-10 |
1427396969 | Alison Elizabeth Jackson | Pharmacist | 944 Sw 9th Street, Redmond, OR 97756 | 2013-01-17 |
1083964449 | Julie C Plachta | Mechanotherapist | 654 Nw 4th Street, Redmond, OR 97756 | 2012-09-13 |
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Taxonomy Code | 1223X0400X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Orthodontics and Dentofacial Orthopedics |
That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1902356058 | Roselind Nam Pllc | Dentist | 23535 Ne Novelty Hill Rd # D308, Redmond, WA 98053-5502 | 2016-10-12 |
1316063969 | Bryan K Roos | Dentist | 16150 Ne 85th St Ste 124, Redmond, WA 98052-3544 | 2007-03-22 |
1336286152 | Scot E Burgess | Dentist | 710 Sw Highland Ave, Redmond, OR 97756-3120 | 2007-01-31 |
1376784124 | Danilee K. Baldwin | Dentist | 7530 164th Ave Ne, Suite #a250, Redmond, WA 98052-7812 | 2009-03-07 |
1679735807 | Rose Chen | Dentist | 15640 Redmond Way, Redmond, WA 98052-3831 | 2008-06-29 |
1821216037 | Shengyi Teng | Dentist | 15640 Redmond Way, Redmond, WA 98052-3831 | 2007-04-23 |
1841323946 | Craig David Smith | Dentist | 7530 164th Ave Ne, Ste#a250, Redmond, WA 98052-7812 | 2007-03-14 |
1265565097 | Warner R. Young | Dentist | 8299 161st Ave Ne, Suite 201, Redmond, WA 98052-3860 | 2007-03-13 |
1003908740 | Judy C Chen | Dentist | 15955 Ne 85th St, #102, Redmond, WA 98052-3550 | 2006-09-29 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1124636329 | Daniel Hoopes | Dentist | 979 Young St Ste C, Woodburn, OR 97071-4954 | 2020-07-14 |
1487205233 | J.r. Gregg LLC | Dentist | 1201 Se 223rd Ave Ste 220, Gresham, OR 97030-2578 | 2019-09-24 |
1447721295 | Alix Jisun Leemin | Dentist | 2350 Sw Multnomah Blvd Ste C, Portland, OR 97219-3999 | 2018-12-05 |
1003381914 | Keyan Botsford | Dentist | 1625 E Mcandrews Rd Ste B, Medford, OR 97504-5334 | 2018-10-06 |
1316435241 | Daniel J Floyd Dmd Ms LLC | Dentist | 863 W. Main St., Suite 200, Molalla, OR 97038 | 2018-04-26 |
1891208724 | Jd Miller Dds PC | Dentist | 2250 Nw Flanders St Ste 112, Portland, OR 97210-5409 | 2017-11-14 |
1952761041 | Hi 5 Orthodontics | Dentist | 18325 Sw Alexander, Suite 2, Aloha, OR 97003 | 2016-03-02 |
1992181838 | Shannon Woods | Dentist | 2500 Ne Twin Knolls Dr Ste 250, Bend, OR 97701-4786 | 2015-08-03 |
1790169217 | Ortho Country Orthodontics LLC | Dentist | 1300 Ne Alpha Dr, Mcminnville, OR 97128-9711 | 2015-07-14 |
1033516232 | Dennis Wade Trammell | Dentist | 2215 Willamette St. Suite B, Eugene, OR 97405-2847 | 2014-12-03 |
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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.