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DR. JACKSON LEE SULLIVAN D.D.S. PA NPI 1194733725


NPI Information

NPI: 1194733725
Provider Name: DR. JACKSON LEE SULLIVAN, D.D.S., PA
Classification: Dentist - 1223E0200X
Entity Type: Individual

Specialization: Endodontics

Address:
1906 59TH ST W STE D
BRADENTON, FL
ZIP 34209
Phone: (941) 840-1906
Get Directions

DR. Jackson Lee Sullivan, D.D.S., PA is an endodontics dentist in Bradenton, FL. The provider is 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. DR. Jackson Lee Sullivan, D.D.S., PA NPI is 1194733725. 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:

1906 59TH ST W STE D
BRADENTON, FL
ZIP 34209-639
Phone: (941) 840-1906
Fax: (941) 840-1906

The enumeration date for this NPI number is 8/3/2006 and was last updated on 3/1/2022.


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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223E0200XDentistEndodonticsDN15529FLORIDAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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