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DR. SCOTT LOUIS SULLIVAN DDS
NPI 1063612844
Dentist - General Practice in Santa Rosa, CA

Active since July 20, 2007
76 DOCTORS PARK DR., SANTA ROSA, CA 95405(707) 546-6367(707) 542-7829 Get Directions Write a Review

NPPES record last updated: July 20, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Scott Louis Sullivan Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SCOTT LOUIS SULLIVAN DDS (NPI 1063612844) is an individual general practice provider in Santa Rosa, California, licensed in California (44095) and active in the NPI registry since July 2007.

NPPES Registry Identity

NPI1063612844
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. SCOTT LOUIS SULLIVANCredential: DDS
Location Address76 DOCTORS PARK DR.Santa Rosa, CA 95405-6615
Mailing Address76 Doctors Park Dr.Santa Rosa, CA 95405 · (707) 546-6367 · Fax (707) 542-7829
Phone(707) 546-6367
Fax(707) 542-7829
Sole ProprietorYes
Enumeration DateJuly 20, 2007
✔ NPI 1063612844 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · 44095
Definition
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.
76 DOCTORS PARK DR., Santa Rosa, CA 95405
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Scott Sullivan's NPI number?

The NPI number for Scott Sullivan is 1063612844. It was assigned to this individual provider in the NPPES registry on July 20, 2007.

Where is Scott Sullivan located?

Scott Sullivan practices at 76 Doctors Park Dr., Santa Rosa, CA 95405. The listed phone number is (707) 546-6367.

What is Scott Sullivan's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Scott Sullivan was last updated on July 20, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.