Provider Demographics
NPI:1902271836
Name:SCHMER, JEANETTE DAWN
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:DAWN
Last Name:SCHMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:JEANETTE
Other - Middle Name:DAWN
Other - Last Name:SHAMUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8069 WINONA AVE
Mailing Address - Street 2:
Mailing Address - City:ALLEN PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48101-2227
Mailing Address - Country:US
Mailing Address - Phone:313-720-2625
Mailing Address - Fax:
Practice Address - Street 1:8069 WINONA AVE
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-2227
Practice Address - Country:US
Practice Address - Phone:313-720-2625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-03
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI3641887124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist