Healthcare Provider Details

I. General information

NPI: 1205975455
Provider Name (Legal Business Name): JAMES P. SCHAEFFER D.D.S. DENTAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/05/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 N ROSE AVE
OXNARD CA
93036-5058
US

IV. Provider business mailing address

2150 N ROSE AVE
OXNARD CA
93036-5058
US

V. Phone/Fax

Practice location:
  • Phone: 805-604-0449
  • Fax: 805-604-4497
Mailing address:
  • Phone: 805-604-0449
  • Fax: 805-604-4497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number43855
License Number StateCA

VIII. Authorized Official

Name: JAMES P SCHAEFFER
Title or Position: PRESIDENT
Credential: DDS
Phone: 805-604-0449