DR. JACKSON LEE SULLIVAN D.D.S., PA
NPI 1194733725
Dentist - Endodontics in Bradenton, FL

Q: What is Jackson Sullivan's NPI number?

The NPI number for Jackson Sullivan is 1194733725. It was assigned to this individual provider in the NPPES registry on August 3, 2006.

Q: What is Jackson Sullivan's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

Q: When was this NPI record last updated?

The NPPES record for Jackson Sullivan was last updated on March 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since August 03, 2006

1906 59TH ST W STE D, BRADENTON, FL 34209(941) 840-1906(941) 840-1906 Get Directions Write a Review

NPPES record last updated: March 1, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Jackson Lee Sullivan D.d.s., Pa NPPES

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

DR. JACKSON LEE SULLIVAN D.D.S., PA (NPI 1194733725) is an individual endodontics provider in Bradenton, Florida, licensed in Florida (DN15529) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1194733725

Entity TypeIndividualMale

Primary Taxonomy1223E0200X

Provider Legal NameDR. JACKSON LEE SULLIVANCredential: D.D.S., PA

Location Address1906 59TH ST W STE DBradenton, FL 34209-4639

Mailing Address1906 59th St W Ste DBradenton, FL 34209-4639 · (941) 840-1906 · Fax (941) 840-1906

Phone(941) 840-1906

Fax(941) 840-1906

Sole ProprietorNo

Enumeration DateAugust 3, 2006

Last NPPES UpdateMarch 1, 2022

NPPES CertifiedMarch 1, 2022

✔ NPI 1194733725 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · EndodonticsDental Providers

Taxonomy Code1223E0200X

License✔ Licensed in FL · DN15529

Definition

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.

1906 59TH ST W STE D, Bradenton, FL 34209

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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. CHARLES CARMINE TOMEO D.M.D

Dentist (Oral and Maxillofacial Surgery)

1906 59TH ST W STE D
BRADENTON, FL 34209

Manatee County (941) 792-0088

DR. CHARLES ANGELO TOMEO DMD

Dentist (Oral and Maxillofacial Surgery)

1906 59TH ST W STE D
BRADENTON, FL 34209

Manatee County (947) 792-0088

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 Jackson Sullivan's NPI number?

The NPI number for Jackson Sullivan is 1194733725. It was assigned to this individual provider in the NPPES registry on August 3, 2006.

Where is Jackson Sullivan located?

Jackson Sullivan practices at 1906 59th St W Ste D, Bradenton, FL 34209. The listed phone number is (941) 840-1906.

What is Jackson Sullivan's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Endodontics, with taxonomy code 1223E0200X.

When was this NPI record last updated?

The NPPES record for Jackson Sullivan was last updated on March 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.