Healthcare Provider Details

I. General information

NPI: 1194826867
Provider Name (Legal Business Name): WARREN JAMES SCHLOTT D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 10/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 E BIRCH ST SUITE 101
BREA CA
92821-5155
US

IV. Provider business mailing address

1220 E BIRCH ST SUITE 101
BREA CA
92821-5155
US

V. Phone/Fax

Practice location:
  • Phone: 714-529-5921
  • Fax: 714-529-9609
Mailing address:
  • Phone: 714-529-5921
  • Fax: 714-529-9609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number27683
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: