Provider Demographics
NPI:1962590463
Name:SWEENEY, JAMES III
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:SWEENEY
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7930 MACARTHUR BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94605-3362
Mailing Address - Country:US
Mailing Address - Phone:510-562-0508
Mailing Address - Fax:510-562-2615
Practice Address - Street 1:7930 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94605-3362
Practice Address - Country:US
Practice Address - Phone:510-562-0508
Practice Address - Fax:510-562-2615
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA225521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice