Provider Demographics
NPI:1902948573
Name:SCHMIDT, GEORGE J JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:J
Last Name:SCHMIDT
Suffix:JR
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 1:197 RIDEGDALE AVE
Mailing Address - Street 2:SUITE 245
Mailing Address - City:CEDAR KNOLLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07927
Mailing Address - Country:US
Mailing Address - Phone:973-889-1900
Mailing Address - Fax:973-887-4669
Practice Address - Street 1:197 RIDEGDALE AVE
Practice Address - Street 2:SUITE 245
Practice Address - City:CEDAR KNOLLS
Practice Address - State:NJ
Practice Address - Zip Code:07927
Practice Address - Country:US
Practice Address - Phone:973-889-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-12
Last Update Date:2020-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY054667-11223G0001X
NJDI020415122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice