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

Jerry L Sullivan, DDS

Individual provider General Practice Dentistry · NPI 1093929044

Jerry L Sullivan, DDS is a General Practice Dentistry in Kingman, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2007
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.

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Practice location Address checks out

411 Grandview Ave
Kingman, AZ 86401-5745
Phone: (928) 753-6611
Fax: (928) 753-1288
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 3296 (AZ)

Record details

NPI number1093929044
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorYes
NPI enumeratedMay 9, 2007
Last updated in NPPESJuly 8, 2007
Mailing address411 Grandview Ave, Kingman, AZ 86401-5745

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