Healthcare Provider Details

I. General information

NPI: 1225722341
Provider Name (Legal Business Name): CHRISTOPHER KRISHNA SCHAUDT I DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2023
Last Update Date: 06/05/2023
Certification Date: 06/03/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4880 W FLAMINGO RD
LAS VEGAS NV
89103-3704
US

IV. Provider business mailing address

7716 MAPLE MEADOW ST
LAS VEGAS NV
89131-4666
US

V. Phone/Fax

Practice location:
  • Phone: 702-687-7000
  • Fax:
Mailing address:
  • Phone: 702-292-9658
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number7830
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: