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JACOB SULLIVAN
NPI 1922633080
Dentist in Kirtland Afb, NM

Active since March 10, 2020
2050A 2ND ST SE, KIRTLAND AFB, NM 87117(505) 846-3200 Get Directions Write a Review

NPPES record last updated: September 28, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 28, 2021, Jul 28, 2021, Mar 27, 2020 and 1 more (4 updates tracked since 2020).

About Jacob Sullivan NPPES

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

JACOB SULLIVAN (NPI 1922633080) is an individual dentist in Kirtland Afb, New Mexico, licensed in Arizona (D010709) and active in the NPI registry since March 2020.

NPPES Registry Identity

NPI1922633080
Entity TypeIndividualMale
Primary Taxonomy122300000X
Provider Legal NameJACOB SULLIVAN
Location Address2050A 2ND ST SEKirtland Afb, NM 87117-5522
Mailing Address2050a 2nd St SeKirtland Afb, NM 87117-5901
Phone(505) 846-3200
Sole ProprietorNo
Enumeration DateMarch 10, 2020
Last NPPES UpdateSeptember 28, 20214 updates tracked since enumeration
NPPES CertifiedSeptember 13, 2021
✔ NPI 1922633080 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers
Taxonomy Code122300000X
License✔ Licensed in AZ · D010709
Definition
A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.
2050A 2ND ST SE, Kirtland Afb, NM 87117
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Other Providers at the Same Location NPPES 20

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

DR. MICHAEL CARVAJAL PSY.D.
Psychologist (Clinical)
2050A 2ND ST SE
KIRTLAND AFB, NM 87117
Bernalillo County (505) 846-3200
FRANCISCO F. GALLARDO JR. DDS, MS
Dentist (Prosthodontics)
2050A 2ND ST SE
KIRTLAND AFB, NM 87117
Bernalillo County (505) 846-3027
PAIGE LOREEN ANDRE-HUDSON
Social Worker (Clinical)
2050A 2ND ST SE
KIRTLAND AFB, NM 87117
Bernalillo County (505) 846-3200
THOMAS POWELL MD
Emergency Medicine
2050A 2ND ST SE
KIRTLAND AFB, NM 87117
Bernalillo County (505) 846-3200
JAROM JARDINE DO
Pediatrics
2050A 2ND ST SE
KIRTLAND AFB, NM 87117
Bernalillo County (505) 846-3200
DR. TAMERA BORCHARDT WHNP. DNP
Nurse Practitioner (Women's Health)
2050A 2ND ST SE
ALBUQUERQUE, NM 87117
Bernalillo County (505) 846-3200
DR. MARY ANN TERESE ORZECH M.D.
Preventive Medicine (Occupational Medicine)
2050A 2ND ST SE
KIRTLAND AFB, NM 87117
Bernalillo County (505) 846-2520
DR. LETICIA R TURNER O.T.D.
Occupational Therapist
2050A 2ND ST SE
KIRTLAND AFB, NM 87117
Bernalillo County (505) 846-3200

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 Jacob Sullivan's NPI number?

The NPI number for Jacob Sullivan is 1922633080. It was assigned to this individual provider in the NPPES registry on March 10, 2020.

Where is Jacob Sullivan located?

Jacob Sullivan practices at 2050A 2nd St SE, Kirtland Afb, NM 87117. The listed phone number is (505) 846-3200.

What is Jacob Sullivan's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

When was this NPI record last updated?

The NPPES record for Jacob Sullivan was last updated on September 28, 2021. 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.