Jackson L. Sullivan D.D.S., P.C.
NPI 1336366244ActiveOrganization· Dentist, Endodontics· Edmond, OK
Dentist, Endodontics in Edmond, Oklahoma, registered in NPPES in April 2007, part of Jackson L. Sullivan D.D.S., P.C. The authorized official on file is Jackson L. Sullivan, DDS, Doctor.
Overview
| NPI | 1336366244 |
|---|---|
| Status | Active |
| Entity type | Organization (subpart) |
| Parent organization | Jackson L. Sullivan D.D.S., P.C. |
| NPI issued | Apr 20, 2007 |
| Last updated in NPPES | Jun 12, 2008 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dentist, Endodontics Primary | 1223E0200X | 5244 | OK |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|