Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JACOB SULLIVAN
ActiveJACOB SULLIVAN is a Dentist healthcare provider located in KIRTLAND AFB, New Mexico. NPI 1922633080 is currently active in the NPPES registry. Verify at CMS.
Dentist · KIRTLAND AFB, NM
Registration Details
- NPI Number
- 1922633080
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 10, 2020 (6.3945016286021 yrs)
- Last Updated
- Sep 28, 2021
- License
-
D010709 (AZ)
Practice Information
- Address
-
2050A 2ND ST SEKIRTLAND AFB, NM, 871175522Browse NM providers · Browse ZIP 87117
- Phone
- 5058463200
- Primary Specialty
-
Dentist
122300000X
Other Dentist Providers in KIRTLAND AFB, NM
| Name | Credential | NPI |
|---|---|---|
| DR. CHADWYCK R BRADLEY | DMD | 1679721054 |
| DR. LINDSAY ORTMAN | D.M.D | 1992294961 |
| BENJAMIN WANG | DDS | 1679139877 |
| SATPAL S JUTLA | DMD | 1447839600 |
| MARIAH GORDON | — | 1588410294 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.