STACY LYNN SULLIVAN (NPI# 1598019325) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598019325 |
| Entity Type | Individual |
| Full Name | STACY LYNN SULLIVAN |
| Other Name | STACY LYNN BAKER |
| Credential | DDS, MS |
| Practice Address |
36600 Heritage Dr Richmond MI 48062-1937 |
| Mailing Address |
450 Oak Ave Unit 303 Birmingham MI 48009-1389 |
| Practice Telephone | 5867275500 |
| Mailing Telephone | 7349457435 |
| Enumeration Date | 2012-10-31 |
| Last Update Date | 2014-10-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
2901021156 | MI | Dental Providers |
| N | 1223P0221X |
Dentist Specialization: Pediatric Dentistry |
319.018288 | IL | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497065213 | Stacy Sullivan | Speech-Language Pathologist | 235 Jackson Crescent, Centerport, NY 11721 | 2010-10-14 |
| 1457876062 | Stacy L Sullivan | Counselor | 6502 Grand Teton Plz Ste 204, Madison, WI 53719-1047 | 2017-08-04 |
| 1306987631 | Stacy Anne Sullivan | Dentist | 217 E Willow St, Yadkinville, NC 27055-8193 | 2007-02-09 |
| Street Address |
36600 HERITAGE DR |
| City | RICHMOND |
| State | MI |
| Zip Code | 48062-1937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104963677 | Frank J. Markie | Dentist | 36600 Heritage Dr, Richmond, MI 48062 | 2007-01-31 |
| 1629561253 | Cole P Mccloskey | Dentist | 36600 Heritage Dr, Richmond, MI 48062-1937 | 2018-06-08 |
| 1730484791 | Peter Andrew Gadioli | Dentist | 36600 Heritage Dr, Richmond, MI 48062-1937 | 2011-01-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184110645 | Lisa Marie Pollauf | Occupational Therapist | 5383 Hessen Rd, Casco, MI 48062 | 2018-07-09 |
| 1073010211 | Alaina Miron | Physical Therapist | Medilodge of Richmond 34901 Division, Richmond, MI 48062 | 2018-04-12 |
| 1841450988 | Thomas Anthony Campbell-cormier | Dentist | 35035 Helze Ln, Richmond Township, MI 48062 | 2008-06-12 |
| 1649438797 | Richmond Physical Therapy Inc | Physical Therapist | 67505 Main Street, Richmond, MI 48062 | 2008-05-27 |
| 1295941391 | John Francis King | Social Worker | 35000 Division, Suite 2, Richmond, MI 48062 | 2007-05-15 |
| 1033256508 | Brian J. Pradko | Dentist | 36600 Heritage Dr., Richmond, MI 48062 | 2007-01-31 |
| 1336286897 | Pradko, Gallagher & Slance, Pllc | Dentist | 36600 Heritage Drive, Richmond, MI 48062 | 2007-01-31 |
| 1538215967 | Kenneth Edward Niemi | Dentist | 68720 Main St, Richmond, MI 48062 | 2007-01-26 |
| 1295824068 | Richmond Lenox Ems Ambulance Authority | Public Health or Welfare | 34505 32 Mile Road, Richmond, MI 48062 | 2006-10-12 |
| 1457459471 | Nancy Barbour | Social Worker | 67515 Main Street, Suite C, Richmond, MI 48062 | 2006-09-21 |
| Find all providers in zip 48062 | ||||
| Taxonomy Code | 1223P0221X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Pediatric Dentistry |
| An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578115275 | H&a Orthodontics | Dentist | 16733 W Airport Blvd, Building A, Suite 2, Richmond, TX 77407 | 2019-07-12 |
| 1528627916 | Petite Smiles Pediatric Dentistry, Pllc | Dentist | 11131 Harlem Rd, Suite 120, Richmond, TX 77406 | 2019-06-10 |
| 1144627555 | David W Merrell Dds Msd Plc | Dentist | 12205 Gayton Road, Suite A, Richmond, VA 23238-3212 | 2014-12-01 |
| 1356559777 | Jeffrey Lucas Bowen | Dentist | 120 Meridian Way, Suite 2, Richmond, KY 40475 | 2007-05-18 |
| 1396890927 | Rhonda H. Cormney | Dentist | 519 Hampton Way Ste 1, Richmond, KY 40475-8885 | 2007-01-24 |
| 1548334071 | William O Dahlke Jr. | Dentist | 521 N 11th St Ste 305, Richmond, VA 23298 | 2006-11-17 |
| 1619054939 | James M Keeton Jr. | Dentist | 7410 Hull Street Rd, Richmond, VA 23235-5834 | 2006-11-01 |
| 1295825123 | Jack J. Reynolds Jr. | Dentist | 1002 Oak Dr, Richmond, IN 47374-1916 | 2006-10-13 |
| 1861597718 | Hayden R. Phillips | Dentist | 1012 Ival James Blvd, C, Richmond, KY 40475-8174 | 2006-09-14 |
| 1093819013 | Jeffrey Patrick Blair | Dentist | 12205 Gayton Rd, Richmond, VA 23238-3219 | 2006-09-11 |
| Find all providers in RICHMOND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.