Sullivan, Jennifer Angela

Sullivan, Jennifer Angela is an individual health care provider with primary practice located at 3200 Andrews Hwy Suite 400, Midland TX 79701-3896. She recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as her primary health care specialty. Sullivan, Jennifer Angela can be contacted via phone (432) 218-7926.

Contact Information

Primary practice address
3200 Andrews Hwy Suite 400 Midland TX 79701-3896
Phone: (432) 218-7926
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 31170 Texas
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 8160 Kentucky
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 12011561A Indiana

Profile Details

NPI number 1871693705
LBN Legal business name Sullivan, Jennifer Angela
Credentials DMD, MS
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2006
Last updated Oct 22nd, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871693705 NPPES
Kentucky MEDICAID 9177836
Kentucky MEDICAID 60003134

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