Healthcare Provider Details

I. General information

NPI: 1114247293
Provider Name (Legal Business Name): ANDREA E SCHMIDT D.D.S.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2010
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1840 FOLSOM ST STE 303
BOULDER CO
80302-5712
US

IV. Provider business mailing address

1840 FOLSOM ST STE 303
BOULDER CO
80302-5712
US

V. Phone/Fax

Practice location:
  • Phone: 303-544-9636
  • Fax: 303-444-4120
Mailing address:
  • Phone: 303-544-9636
  • Fax: 303-444-4120

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number10454
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: