DR. PREDDIS LEROY SULLIVAN DDS NPI 1477616662

NPI Information

NPI: 1477616662
Provider Name: DR. PREDDIS LEROY SULLIVAN, DDS
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

Address:
1619 N WATERFRONT PKWY
WICHITA, KS
ZIP 67206
Phone: (316) 462-3354
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DR. Preddis Leroy Sullivan, DDS is a general practice dentist in Wichita, KS. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Preddis Leroy Sullivan, DDS NPI is 1477616662. 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:

1619 N WATERFRONT PKWY
WICHITA, KS
ZIP 67206-602
Phone: (316) 462-3354

The enumeration date for this NPI number is 12/18/2006 and was last updated on 7/31/2019.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	54500	CALIFORNIA	Yes

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

NPI Synchronization or Removal

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