# TARA SULLIVAN, DDS PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** THE DENTAL SHOPPE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1215295498
- **Authorized official:** TARA MARIE SULLIVAN DDS (OWNER)
- **Authorized official phone:** (206) 829-8432

## Contact information

- **Practice address:** 1203 E PINE STREET, SEATTLE, WA 98122
- **Practice address phone:** (206) 829-8432
- **Mailing address:** 1203 E PINE STREET, SEATTLE, WA 98122
- **Mailing address phone:** (206) 829-8432

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00010943 | WA | Yes |

## Other

- **Enumeration date:** 04/25/2012
- **Last updated:** 04/25/2012