Provider Demographics
NPI:1831777523
Name:SCHIAPPA, MICHAEL BENEDICT (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BENEDICT
Last Name:SCHIAPPA
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 1:1420 28TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80303-1081
Mailing Address - Country:US
Mailing Address - Phone:303-444-2255
Mailing Address - Fax:
Practice Address - Street 1:1420 28TH ST STE 100
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80303-1081
Practice Address - Country:US
Practice Address - Phone:303-444-2255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2025-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019.033195390200000X
CODEN.002061011223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program