Healthcare Provider Details

I. General information

NPI: 1780608562
Provider Name (Legal Business Name): MICHAEL JOHN SCHEIDT DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/26/2006
Last Update Date: 09/03/2024
Certification Date: 09/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

777 BANNOCK ST
DENVER CO
80204-4597
US

IV. Provider business mailing address

11160 HURON ST SUITE 101
NORTHGLENN CO
80234-4377
US

V. Phone/Fax

Practice location:
  • Phone: 303-436-4949
  • Fax: 303-436-4748
Mailing address:
  • Phone: 303-457-9617
  • Fax: 303-457-2405

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDEN.00007546
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number7546
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: