Healthcare Provider Details

I. General information

NPI: 1922174895
Provider Name (Legal Business Name): BURTON D. SCHNIEROW, DDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/24/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13450 HAWTHORNE BLVD
HAWTHORNE CA
90250-5806
US

IV. Provider business mailing address

13450 HAWTHORNE BLVD
HAWTHORNE CA
90250-5806
US

V. Phone/Fax

Practice location:
  • Phone: 310-679-0106
  • Fax: 310-679-6698
Mailing address:
  • Phone: 310-679-0106
  • Fax: 310-679-6698

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number48619
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number16629
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number17750
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number43530
License Number StateCA
# 5
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number47526
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number19083
License Number StateCA

VIII. Authorized Official

Name: DR. BURTON SCHNIEROW
Title or Position: PRESIDENT
Credential: D.D.S.
Phone: 310-679-0106