Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1194733725 Individual Practitioner Male Practitioner

Dr. Jackson Lee Sullivan , DDS, PA

Dentist - Endodontics • Bradenton, FL

Professional Overview & Biography Verified Profile Summary

Dr. Jackson Sullivan, DDS, PA is a registered healthcare professional specializing in Dentist - Endodontics in Bradenton, FL. Practice services are available at 1906 59TH ST W STE D under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1906 59th St W Ste D

Bradenton, FL 342094639

Telephone 9418401906
Fax 9418401906

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - Endodontics in Bradenton, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
6 Specialists

Practicing in Bradenton, FL (536 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

CMS Verified: 2022-03-01
Dentist - Endodontics Primary Specialty

NUCC Taxonomy Code: 1223E0200X

State License FL DN15529

The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions.

Practice Associates & Co-Workers

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

2 Associated Practitioners
Dr. Charles Tomeo , DMD

Dentist - Oral and Maxillofacial Surgery

NPI 1245346055

Doctor of Dental Medicine

Dr. Charles Tomeo , DMD

Dentist - Oral and Maxillofacial Surgery

NPI 1831208008

Doctor of Dental Medicine

Career & Practice History Timeline

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

10 Historical Events
📍
Updated Practice Location March 01, 2022

Registered at 1906 59TH ST W STE D, BRADENTON, FL 342094639 (Tel: 9418401906)

📍
Updated Business Mailing Address March 01, 2022

Registered at 1906 59TH ST W STE D, BRADENTON, FL 342094639 (Tel: 9418401906)

👤
Provider Name / Credentials Updated March 01, 2022

Recorded as JACKSON SULLIVAN, D.D.S., PA

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 01, 2022

Dentist (License #DN15529 in FL)

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 08, 2007

Registered at 609 S KELLY AVE, E-1, EDMOND, OK 730035659 (Tel: 4058448444)

📍
Updated Business Mailing Address July 08, 2007

Registered at 609 S KELLY AVE, E-1, EDMOND, OK 730035659 (Tel: 4058448444)

👤
Provider Name / Credentials Updated July 08, 2007

Recorded as JACKSON SULLIVAN, D.D.S., PC

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #5244 in OK)

🟢
Initial NPI Registration & Enumeration August 03, 2006

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: 1194733725
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 03, 2006
Last Update: March 01, 2022
Sole Proprietor: No

Mailing Address

1906 59th St W Ste D

Bradenton, FL 342094639

Phone: 9418401906

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.