MEDICARE: DR. JAMES EDWARD SWEENEY DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	DS014131L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	DS014131L	OTHER	PA	LICENSE NUMBER

General Provider Information

NPI Number	:	1548399702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES EDWARD SWEENEY DDS

Provider Business Mailing Address
First Line	:	6 WEXFORD LN
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15235-4741
Country	:	US
Telephone Number	:	412-400-9346
Fax Number	:	412-828-7073

Provider Business Practice Location Address
First Line	:	6 WEXFORD LN
Second Line	:
City	:	PITTSBURGH
State	:	PA
Zip	:	15235-4741
Country	:	US
Telephone Number	:	412-400-9346
Fax Number	:	412-828-7073

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/05/2007
Last Update Date	:	07/08/2007

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