Active NPI
Dale Roy Sweeney, D.D.S., M.S.
- Periodontics
- Port Huron, MI
National Provider Identifier
1659341329
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 2901015905
- Practice address
- 2425 Military Street
BLDG. 3
Port Huron, MI 48060 - Phone
- (810) 985-6600
- Fax
- (810) 985-6675
- NPI assigned
- Jan 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 2901015905 | MI | Primary |
Addresses
Primary practice location
2425 Military Street
BLDG. 3
Port Huron, MI 48060
Mailing address
2425 Military Street
BLDG. 3
Port Huron, MI 48060
Phone (810) 985-6600
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170330000913 | MI | Order and Referring Only - Other (Physician) | 8325108764 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138147200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228089600000",
"number": "1659341329",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2425 MILITARY STREET",
"address_2": "BLDG. 3",
"city": "PORT HURON",
"state": "MI",
"postal_code": "48060",
"telephone_number": "810-985-6600",
"fax_number": "810-985-6675"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2425 MILITARY STREET",
"address_2": "BLDG. 3",
"city": "PORT HURON",
"state": "MI",
"postal_code": "48060",
"telephone_number": "810-985-6600",
"fax_number": "810-985-6675"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SWEENEY",
"first_name": "DALE",
"middle_name": "ROY",
"name_prefix": "Dr.",
"credential": "D.D.S., M.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-01-25",
"last_updated": "2008-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "MI",
"license": "2901015905",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Port Huron, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.