DR. JAY SCOTT SULLINS (NPI# 1992843965) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1992843965 |
Entity Type | Individual |
Full Name | DR. JAY SCOTT SULLINS |
Credential | D.D.S. |
Practice Address |
8504 Nw Cache Rd Lawton OK 73505-9604 |
Practice Telephone | 5802483636 |
Practice Fax Number | 5802483533 |
Mailing Telephone | 5802483636 |
Mailing Fax Number | 5802483533 |
Enumeration Date | 2007-02-02 |
Last Update Date | 2007-07-08 |
Gender Code | M |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 1223E0200X |
Dentist Specialization: Endodontics |
38 | OK | Dental Providers |
Street Address |
8504 NW CACHE RD |
City | LAWTON |
State | OK |
Zip Code | 73505-9604 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1548556327 | Lawton Endodontics | Dentist | 8504 Nw Cache Rd, Lawton, OK 73505-9604 | 2011-06-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1134744006 | Angela Janell Smith | Case Manager/Care Coordinator | 4904 Nw Smith Ave, Lawton, OK 73505 | 2020-06-16 |
1295383990 | Akeemia Lorene Holder | Case Manager/Care Coordinator | Youth Care of Oklahoma, 713 Sw C Avenue, OK 73505 | 2019-08-27 |
1225685480 | Healthstat Onsite Clinic Goodyear Vision Center | Preventive Medicine | 1 Goodyear Blvd, Lawton, OK 73505 | 2019-08-22 |
1891285300 | Michael Anthony Gray | Case Manager/Care Coordinator | 2218 Nw 36th St, Lawton, OK 73505 | 2018-05-10 |
1841797362 | Adeshola T Fatuyi | Case Manager/Care Coordinator | 7301 Sw Lee 635, Lawton, OK 73505 | 2018-04-11 |
1912425539 | Heather Shea Morefield | Case Manager/Care Coordinator | 2712 Sw H Ave, Lawton, OK 73505 | 2017-09-04 |
1972031367 | Burke Hendricks | Emergency Medicine | 3401 West Gore Boulevard, Lawton, OH 73505 | 2017-05-30 |
1932642279 | Helery Vance | Peer Specialist | 1420 Nw Hunter Rd Apt C7, Lawton, OK 73505 | 2016-11-18 |
1629523436 | Sebrina Sheppard | Case Manager/Care Coordinator | 3907 Sw Parkridge Blvd., Lawton, OK 73505 | 2016-08-22 |
1376913590 | David Lee Atauvich | Registered Nurse | 1515 Lawrie Rd, Lawton, OK 73505 | 2015-09-30 |
Find all providers in zip 73505 |
Taxonomy Code | 1223E0200X |
Grouping | Dental Providers |
Classification | Dentist |
Specialization | Endodontics |
The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
Notes: Source: Council on Dental Education and Licensure, American Dental Association |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1821078700 | Roger Satoru Nishimura Jr. | Dentist | 1008 Sw C Ave, Suite 102, Lawton, OK 73501-4300 | 2006-01-18 |
1548556327 | Lawton Endodontics | Dentist | 8504 Nw Cache Rd, Lawton, OK 73505-9604 | 2011-06-21 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1891008272 | Reham El-hennawey | Dentist | 400 Riverwalk Ter, Ste 200, Jenks, OK 74037-5606 | 2010-07-14 |
1770713729 | Eugenia Johnson | Dentist | 4416 W Houston St, Broken Arrow, OK 74012-4645 | 2009-07-23 |
1013187186 | Denny W Southard | Dentist | 6565 S Yale Ave Ste 712, Tulsa, OK 74136-8308 | 2008-03-05 |
1972703734 | J. Mike Strand | Dentist | 4420 W Houston St, Broken Arrow, OK 74012-4645 | 2007-07-20 |
1629290242 | Kim Loren Wilkinson | Dentist | 13851 Quail Pointe Dr, Oklahoma City, OK 73134-1021 | 2007-05-03 |
1336366244 | Jackson L. Sullivan D.d.s., P.C. | Dentist | 609 S Kelly Ave Ste E1, Edmond, OK 73003-7501 | 2007-04-20 |
1861532616 | Steven Eugene Powell | Dentist | 410 24th Ave Sw, Norman, OK 73069-5110 | 2007-02-08 |
1760536866 | David W Pedicord | Dentist | 4606 E 67th Street, Suite 208, Tulsa, OK 74136 | 2007-01-23 |
1437207560 | David J Clement | Dentist | 1201 N Stonewall Ave., Ouhsc College of Dentistry, Oklahoma City, OK 73117 | 2007-01-08 |
1982616256 | William Lee Beasley I | Dentist | 4500 Memorial Cir, Oklahoma City, OK 73142-5003 | 2006-08-13 |
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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.