Provider Demographics
NPI:1679312169
Name:SCHOENFELD ORTHODONTICS
Entity type:Organization
Organization Name:SCHOENFELD ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORTHODONTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHOENFELD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:772-589-5959
Mailing Address - Street 1:621 SEBASTIAN BLVD.
Mailing Address - Street 2:UNIT D
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32958
Mailing Address - Country:US
Mailing Address - Phone:772-589-5959
Mailing Address - Fax:772-589-1450
Practice Address - Street 1:621 SEBASTIAN BLVD.
Practice Address - Street 2:UNIT D
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32958
Practice Address - Country:US
Practice Address - Phone:772-589-5959
Practice Address - Fax:772-589-1450
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-23
Last Update Date:2024-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty