MEDICARE: DR. CHRISTOPHER DEAN SCHULTEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	6764	KY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1659443521	OTHER	KY	DENTIST

General Provider Information

NPI Number	:	1659443521
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER DEAN SCHULTEN

Provider Business Mailing Address
First Line	:	5207 COMMERCE CROSSINGS DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40229-2183
Country	:	US
Telephone Number	:	502-968-7878
Fax Number	:	502-968-2378

Provider Business Practice Location Address
First Line	:	5207 COMMERCE CROSSINGS DR
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40229-2183
Country	:	US
Telephone Number	:	502-968-7878
Fax Number	:	502-968-2378

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/15/2006
Last Update Date	:	04/11/2019

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