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SCOTT R SULLIVAN DDS, MD
NPI 1972134567
Dentist - Oral and Maxillofacial Surgery in Springfield, MO

Active since February 01, 2020PECOS Enrolled
1103 E MONTCLAIR ST, SPRINGFIELD, MO 65807(316) 616-8157 Get Directions Write a Review

NPPES record last updated: February 18, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Scott R Sullivan Dds, Md NPPES

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

SCOTT R SULLIVAN DDS, MD (NPI 1972134567) is an individual oral and maxillofacial surgery provider in Springfield, Missouri, licensed in Missouri (2025018574) and active in the NPI registry since February 2020. He is enrolled in Medicare PECOS and is a graduate of University Of Missouri, Kansas City, School Of Medicine (2020).

NPPES Registry Identity

NPI1972134567
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameSCOTT R SULLIVANCredential: DDS, MD
Location Address1103 E MONTCLAIR STSpringfield, MO 65807-5076
Mailing Address4649 Cole Ave Apt 116Dallas, TX 75205-4043 · (316) 616-8157
Phone(316) 616-8157
Sole ProprietorNo
Medical School CMSUniversity Of Missouri, Kansas City, School Of MedicineGraduated 2020
Enumeration DateFebruary 1, 2020
Last NPPES UpdateFebruary 18, 2026
NPPES CertifiedFebruary 18, 2026
✔ NPI 1972134567 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in MO · 2025018574
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
1103 E MONTCLAIR ST, Springfield, MO 65807
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Scott R Sullivan Dds, Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9133603343
PECOS Enrollment IDI20260325000985
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65807 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$81.64 typical visit price
range $52.28 – $161.24
Typical copayment $20.41 (range $13.07 – $40.31)
Most-billed visit code 99203
Established Patient
$65.71 typical visit price
range $16.30 – $131.05
Typical copayment $16.42 (range $4.07 – $32.76)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

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

DR. STEVEN P QUINN DDS
Dentist (Oral and Maxillofacial Surgery)
1103 E MONTCLAIR ST, SUITE 100
SPRINGFIELD, MO 65807
Greene County (417) 887-8800
MRS. TRACY L BECKHAM CRNA
Nurse Anesthetist, Certified Registered
1103 E MONTCLAIR ST, SUITE 110
SPRINGFIELD, MO 65807
Greene County (417) 447-2482
DR. JAMES DAVID GIPSON DDS MD
Dentist (Oral and Maxillofacial Surgery)
1103 E MONTCLAIR ST, SUITE 100
SPRINGFIELD, MO 65807
Greene County (417) 887-8800
DR. GEORGE E ARQUITT III DDS, MD
Dentist (Oral and Maxillofacial Surgery)
1103 E MONTCLAIR ST, SUITE 100
SPRINGFIELD, MO 65807
Greene County (417) 887-8800
GIPSON, ARQUITT, MEYER AND SHANER DDS, PC
Dentist (Oral and Maxillofacial Surgery)
1103 E MONTCLAIR ST, SUITE 100
SPRINGFIELD, MO 65807
Greene County (417) 887-8800
DR. THOMAS A COLLINS JR. DDS
Dentist (Oral and Maxillofacial Surgery)
1103 E MONTCLAIR ST, SUITE 100
SPRINGFIELD, MO 65807
Greene County (417) 887-8800
CHRISTOPHER MICHAEL MEYER D.D.S., M.D.
Dentist (Oral and Maxillofacial Surgery)
1103 E MONTCLAIR ST
SPRINGFIELD, MO 65807
Greene County (417) 887-8800
ORAL ANESTHESIA GROUP INC
Anesthesiology
1103 E MONTCLAIR ST, SUITE 110
SPRINGFIELD, MO 65807
Greene County (417) 447-2482

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 1972134567. It was assigned to this individual provider in the NPPES registry on February 1, 2020.

Where is Scott Sullivan located?

Scott Sullivan practices at 1103 E Montclair St, Springfield, MO 65807. The listed phone number is (316) 616-8157.

What is Scott Sullivan's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Scott Sullivan enrolled in Medicare?

Yes. Scott Sullivan is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Scott Sullivan was last updated on February 18, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 months 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.