Individual provider Active NPI

Sean Vreeburg, D.D.S.

  • Dentist
  • Santa Rosa, CA
National Provider Identifier
1225437254
Registry record updated Aug 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
63803 Issued in CA
Practice address
3599 Piner Rd
Santa Rosa, CA 95401-3916
Phone
(707) 490-9084
NPI assigned
Aug 14, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 63803 CA Primary

Addresses

Primary practice location

3599 Piner Rd
Santa Rosa, CA 95401-3916

Mailing address

3599 Piner Rd
Santa Rosa, CA 95401-3916
Phone (707) 490-9084

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.
Opted out of Medicare
Previously, effective Aug 9, 2018 through Aug 9, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
63803CAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sean K. Vreeburg, DDS, Ms, PC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1407974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407974400000",
    "number": "1225437254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3599 PINER RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954013916",
            "telephone_number": "707-490-9084"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3599 PINER RD",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954013916",
            "telephone_number": "707-490-9084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VREEBURG",
        "first_name": "SEAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-08-14",
        "last_updated": "2014-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63803",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Rosa, CA

Sources for this page

Verify at the official NPI Registry.