Provider Demographics
NPI:1861695462
Name:SCHACHT, STEPHEN MATTHEW (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:MATTHEW
Last Name:SCHACHT
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 1:651 OKEECHOBEE BLVD
Mailing Address - Street 2:UNIT #806
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-6060
Mailing Address - Country:US
Mailing Address - Phone:305-450-9515
Mailing Address - Fax:
Practice Address - Street 1:130 RAMPART WAY STE 100
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-6443
Practice Address - Country:US
Practice Address - Phone:303-341-7151
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-09
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN192881223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SWMC 249-XOtherINSTITUTIONAL PERMIT