Jackson Lee Sullivan, D.D.S., PA

Endodontics · Bradenton, FL

Individual Active NPI

NPI number 1194733725

Practice location

1906 59TH St W Ste D
Bradenton, FL 34209-4639
Phone
(941) 840-1906
Fax
(941) 840-1906

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NPI record

NPI
1194733725
Entity type
Individual (Type 1)
Enumeration date
August 3, 2006
Last updated
March 1, 2022
Certified
March 1, 2022
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Endodontics Primary 1223E0200X DN15529 FL

About Dr. Sullivan

Jackson Lee Sullivan, D.D.S., PA is a healthcare provider registered in the NPI registry with the primary taxonomy Endodontics (code 1223E0200X). The practice location is 1906 59TH St W Ste D, Bradenton, FL 34209-4639. The NPI number 1194733725 was assigned on August 3, 2006 and the record was last updated on March 1, 2022.

Dr. Sullivan lists a license in the registry: #DN15529 (FL) for Endodontics. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Jackson Lee Sullivan, D.D.S., PA?

The NPI number is 1194733725.

What is the phone number of Dr. Sullivan?

The phone number listed for the practice location is (941) 840-1906.

Where is Dr. Sullivan located?

1906 59TH St W Ste D, Bradenton, FL 34209-4639.

What is the taxonomy code for Dr. Sullivan?

The primary taxonomy code is 1223E0200X – Endodontics.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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