BRETT MICHAEL SULLIVAN D.M.D. M.D. NPI 1629268966

NPI Information

Brett Michael Sullivan, D.M.D., M.D. is an oral and maxillofacial surgery dentist in Portland, OR. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. Brett Michael Sullivan, D.M.D., M.D. NPI is 1629268966. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2428 NE WASCO ST
PORTLAND, OR
ZIP 97232
Phone: (541) 301-3818

The NPI 1629268966 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/1/2007 and was last updated on 6/8/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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