Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Jackson Lee Sullivan, DDS, PA

Individual provider Endodontics · NPI 1194733725

Dr. Jackson Lee Sullivan, DDS, PA is an Endodontics in Bradenton, Florida. Licensed in Florida. Registered with an NPI since 2006.

Licensed in
FL
In the registry since
2006
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

1906 59th St W Ste D
Bradenton, FL 34209-4639
Phone: (941) 840-1906
Fax: (941) 840-1906
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Endodontics (primary) Taxonomy 1223E0200X · Licence DN15529 (FL)

Record details

NPI number1194733725
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS , PA
Sole proprietorNo
NPI enumeratedAugust 3, 2006
Last updated in NPPESMarch 1, 2022
Certification dateMarch 1, 2022
Mailing address1906 59th St W Ste D, Bradenton, FL 34209-4639

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