MEDICARE: KAROL ANDREA SULLIVAN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	DE70006637	WA

General Provider Information

NPI Number	:	1134995798
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAROL ANDREA SULLIVAN DDS

Provider Business Mailing Address
First Line	:	1117 27TH AVE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98122-4929
Country	:	US
Telephone Number	:	608-520-7338
Fax Number	:

Provider Business Practice Location Address
First Line	:	3340 NE 125TH ST STE 2
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98125-4591
Country	:	US
Telephone Number	:	206-362-8314
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/27/2023
Last Update Date	:	07/03/2025

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