Provider Demographics
NPI:1649272220
Name:SWEARINGEN, DONALD WAYNE (DDS)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:WAYNE
Last Name:SWEARINGEN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 OLDE TOWNE RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73034-4944
Mailing Address - Country:US
Mailing Address - Phone:405-330-2358
Mailing Address - Fax:
Practice Address - Street 1:11318 N MAY AVE STE B
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-5843
Practice Address - Country:US
Practice Address - Phone:405-751-8092
Practice Address - Fax:405-751-8658
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-12
Last Update Date:2016-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK47971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice