Individual provider Active NPI

Scott Patrick Sweeney, DDS

  • Dentist
  • Vineyard Haven, MA
National Provider Identifier
1396904306
Registry record updated Jul 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN1855151 Issued in MA
Practice address
79 Beach Rd
Vineyard Haven, MA 02568
Phone
(321) 693-9530
NPI assigned
Jun 4, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 23, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN1855151 MA Primary

Addresses

Primary practice location

79 Beach Rd
Vineyard Haven, MA 02568

Mailing address

539 State Rd
Plymouth, MA 02360-5110
Phone (321) 693-9530

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20150601000170 MA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8224359450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN1855151MAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1212537600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248307200000",
    "number": "1396904306",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "539 STATE RD",
            "city": "PLYMOUTH",
            "state": "MA",
            "postal_code": "023605110",
            "telephone_number": "321-693-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 BEACH RD",
            "city": "VINEYARD HAVEN",
            "state": "MA",
            "postal_code": "02568",
            "telephone_number": "321-693-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SWEENEY",
        "first_name": "SCOTT",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-06-04",
        "last_updated": "2009-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DN1855151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vineyard Haven, MA

Sources for this page

Verify at the official NPI Registry.