National Provider Identifier

John P. Sullivan, D.M.D.

John P. Sullivan, D.M.D. is listed in the NPPES registry with a primary specialty of Orthodontics and Dentofacial Orthopedics Dentistry in Pittsford, NY and a listed phone number of (585) 586-7170.

NPI 1992797468Pittsford, NYOrthodontics and Dentofacial Orthopedics Dentistry

Profile Overview

NPI
1992797468
Provider Type
Individual
Primary Specialty
Orthodontics and Dentofacial Orthopedics Dentistry
Enumeration Date
August 19, 2005
Last Updated
January 17, 2012

Practice Location

  • 60 Tobey Village
  • Pittsford, NY 14534-1858

Phone: (585) 586-7170

Mailing Address

  • 105 Neuchatel Ln
  • Fairport, NY 14450-4634

Specialties

  • Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X)
Full Record
NPI
1992797468
Entity Type
Individual
Last Name
Sullivan
First Name
John
Middle Name
P.
Name Prefix
Dr.
Credential
D.M.D.
Mailing Street Address
105 Neuchatel Ln
Mailing City
Fairport
Mailing State
NY
Mailing ZIP Code
14450-4634
Mailing Country
US
Mailing Phone
(585) 586-7170
Practice Street Address
60 Tobey Village
Practice City
Pittsford
Practice State
NY
Practice ZIP Code
14534-1858
Practice Country
US
Practice Phone
(585) 586-7170
Enumeration Date
August 19, 2005
Last Updated
January 17, 2012
Sex
Male
Sole Proprietor
Yes
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X)
Other Identifiers
055771-1 (NY, Nys Dental License)