Individual provider · Type 1 NPI

Scott R. Sullivan, DDS, MD

Oral and Maxillofacial Surgery (Dentist) · Springfield, MO

NPI number 1972134567 Active

Practice location

1103 E Montclair St
Springfield, MO 65807-5076

Call (316) 616-8157 Map

Mailing address

4649 Cole Ave Apt 116
Dallas, TX 75205-4043

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X2025018574 (MO)

Oral and Maxillofacial Surgery (Dentist): The specialty of dentistry which includes 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.

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About NPI 1972134567

Scott R. Sullivan, DDS, MD's National Provider Identifier is 1972134567, issued on Feb 1, 2020. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Springfield, MO. The record was last updated on Feb 18, 2026.