Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1063612844 Individual Practitioner Male Practitioner

Dr. Scott Louis Sullivan , DDS

Dentist - General Practice • Santa Rosa, CA

Professional Overview & Biography Verified Profile Summary

Dr. Scott Sullivan, DDS is a registered healthcare professional specializing in Dentist - General Practice in Santa Rosa, CA. Practice services are available at 76 DOCTORS PARK DR. under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

76 Doctors Park Dr.

Santa Rosa, CA 954056615

Telephone 7075466367
Fax 7075427829

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Santa Rosa, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 43.0 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
116 Specialists

Practicing in Santa Rosa, CA (18734 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License CA 44095

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1104992015

Doctor of Dental Surgery

Dr. Diane Niles , DDS

Dentist - General Practice

NPI 1679584700

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active July 20, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 20, 2007

Registered at 76 DOCTORS PARK DR., SANTA ROSA, CA 954056615 (Tel: 7075466367)

📍
Updated Business Mailing Address July 20, 2007

Registered at 76 DOCTORS PARK DR., SANTA ROSA, CA 95405 (Tel: 7075466367)

👤
Provider Name / Credentials Updated July 20, 2007

Recorded as SCOTT SULLIVAN, DDS

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 20, 2007

Dentist (License #44095 in CA)

🟢
Initial NPI Registration & Enumeration July 20, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1063612844
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 20, 2007
Last Update: July 20, 2007
Sole Proprietor: Yes

Mailing Address

76 Doctors Park Dr.

Santa Rosa, CA 95405

Phone: 7075466367

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.