Individual provider Active NPI

Jeffrey D Sevener, DDS

  • General Practice Dentistry
  • Muskegon, MI
National Provider Identifier
1184953192
Registry record updated Dec 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
17061 Issued in MI
Practice address
1827 W Sherman Blvd
Muskegon, MI 49441-3477
Phone
(231) 755-6515
Fax
(231) 755-9632
NPI assigned
Dec 22, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 17061 MI Primary

Addresses

Primary practice location

1827 W Sherman Blvd
Muskegon, MI 49441-3477

Mailing address

1827 W Sherman Blvd
Muskegon, MI 49441-3477
Phone (231) 755-6515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160531002046 MI Order and Referring Only - DentistPractitioner - Dentist 9032409248

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17061MIMDGeneral Practice Dentistry

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261440000000",
    "number": "1184953192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1827 W SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494413477",
            "telephone_number": "231-755-6515",
            "fax_number": "231-755-9632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1827 W SHERMAN BLVD",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494413477",
            "telephone_number": "231-755-6515",
            "fax_number": "231-755-9632"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SEVENER",
        "first_name": "JEFFREY",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-22",
        "last_updated": "2009-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "17061",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.