Provider Demographics
NPI:1528767373
Name:DAVID E. SCHMIDT, D.D.S., P.C.
Entity type:Organization
Organization Name:DAVID E. SCHMIDT, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:847-234-4800
Mailing Address - Street 1:825 S WAUKEGAN RD STE A1
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-2665
Mailing Address - Country:US
Mailing Address - Phone:847-234-4800
Mailing Address - Fax:847-234-4876
Practice Address - Street 1:825 S WAUKEGAN RD STE A1
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-2665
Practice Address - Country:US
Practice Address - Phone:847-234-4800
Practice Address - Fax:847-234-4876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-01
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Multi-Specialty