Provider Demographics
NPI:1972221968
Name:SWEIGART, TRENTON (DMD)
Entity Type:Individual
Prefix:DR
First Name:TRENTON
Middle Name:
Last Name:SWEIGART
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4504 W SPRUCE ST APT 428
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33607-5889
Mailing Address - Country:US
Mailing Address - Phone:727-424-3301
Mailing Address - Fax:
Practice Address - Street 1:4129 W KENNEDY BLVD STE 1
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33609-2254
Practice Address - Country:US
Practice Address - Phone:813-580-5244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN270231223G0001X
FL270231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice