Healthcare Provider Details

I. General information

NPI: 1568042919
Provider Name (Legal Business Name): MIA SCHMIDT DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2021
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5188 WINTON RD
FAIRFIELD OH
45014-2900
US

IV. Provider business mailing address

5188 WINTON RD
FAIRFIELD OH
45014-2900
US

V. Phone/Fax

Practice location:
  • Phone: 513-829-8080
  • Fax:
Mailing address:
  • Phone: 513-829-8080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number30.026453
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: