Lacey Sullivan, in Hoover, AL - Medicare Dentist Provider

Lacey Sullivan, is a medicare enrolled "Dentist" provider in Hoover, Alabama. Her current practice location is 1015 Brocks Gap Pkwy, Hoover, Alabama. You can reach out to her office (for appointments etc.) via phone at (205) 982-0112.

Lacey Sullivan is licensed to practice in Alabama (license number 6510) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1114412103.

Contact Information

	Lacey Sullivan,
	1015 Brocks Gap Pkwy, Hoover, AL 35244-4032
	(205) 982-0112
	Not Available

Healthcare Provider's Profile

Full Name	Lacey Sullivan
Gender	Female
Speciality	Dentist
Location	1015 Brocks Gap Pkwy, Hoover, Alabama
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1114412103
Provider Enumeration Date: 06/22/2018
Last Update Date: 04/08/2024

Medicare PECOS Information:

PECOS PAC ID: 9335498195
Enrollment ID: I20180828001563

Medical Identifiers

Medical identifiers for Lacey Sullivan such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1114412103	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
122300000X	Dentist	6510 (Alabama)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Lacey Sullivan is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Lacey Sullivan, 1015 Brocks Gap Pkwy, Hoover, AL 35244-4032 Ph: (205) 982-0112	Lacey Sullivan, 1015 Brocks Gap Pkwy, Hoover, AL 35244-4032 Ph: (205) 982-0112

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Dentist in Hoover, AL

Dr. Madeline Gilmer Phillips, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 2034 Patton Chapel Rd, Hoover, AL 35216 Phone: 205-979-9480
Arthur Alvin Jones Iv, D.M.D Dentist Medicare: Not Enrolled in Medicare Practice Location: 1015 Brocks Gap Pkwy, Hoover, AL 35244 Phone: 205-982-0112
Dr. Lauren Elizabeth Denson, D.M.D. Dentist Medicare: Medicare Enrolled Practice Location: 1015 Brocks Gap Pkwy, Hoover, AL 35244 Phone: 615-330-7417
Dr. James Edward Lecroy Iii, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 3055 Lorna Rd Ste 110, Hoover, AL 35216 Phone: 205-822-8161
Dr. Benjamin E Samuelson, DMD, MS Dentist Medicare: Not Enrolled in Medicare Practice Location: 5564 Grove Blvd Ste A, Hoover, AL 35226 Phone: 205-988-9678
Dr. Bailey Adams Walker, DDS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2038 Patton Chapel Rd, Hoover, AL 35216 Phone: 205-822-7822

Lacey Sullivan, - Medicare Dentist in Hoover, AL