Active NPI 1871092502 Individual Practitioner Female Practitioner

Dr. Andrea Lee Sullivan , DMD

Dentist - General Practice • Glen Carbon, IL

Professional Overview & Biography Verified Profile Summary

Dr. Andrea Sullivan, DMD is a registered healthcare professional specializing in Dentist - General Practice in Glen Carbon, IL. Practice services are available at 3024 SOUTH IL-159 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

3024 South Il-159

Glen Carbon, IL 62034

Telephone 8555792158

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Glen Carbon, IL

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 18.0 Yrs

Regional Practice Density

8 Specialists

Practicing in Glen Carbon, IL (5581 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 MO 2018003588

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Missouri Dental Board

2018003588 (MO)

Secondary Practice Locations

1200 Big Bill Rd

Arnold, MO 630102117

Phone: 6369252129

1809 Homer M Adams Pkwy Ste A

Alton, IL 620025606

Phone: 8442190605

Career & Practice History Timeline

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

6 Historical Events

✅

NPI Profile Active February 08, 2018

NPI status registered as active in NPPES database

📍

Updated Practice Location February 08, 2018

Registered at 3024 SOUTH IL-159, GLEN CARBON, IL 62034 (Tel: 8555792158)

📍

Updated Business Mailing Address February 08, 2018

Registered at 902 MONTEREY DR, O FALLON, IL 622692833 (Tel: 6189757454)

👤

Provider Name / Credentials Updated February 08, 2018

Recorded as ANDREA SULLIVAN, DMD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) February 08, 2018

Dentist (License #2018003588 in MO)

🟢

Initial NPI Registration & Enumeration February 08, 2018

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: 1871092502

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: February 08, 2018

Last Update: March 17, 2018

Sole Proprietor: No

Update or Correct Profile

Mailing Address

902 Monterey Dr

O Fallon, IL 622692833

Phone: 6189757454

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.