Healthcare Provider Details

I. General information

NPI: 1841451697
Provider Name (Legal Business Name): KEITH M SCHNEIDER D.M.D., M.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 07/29/2025
Certification Date: 07/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7207 HOPKINS RD ORAL AND MAXILLOFACIAL SURGERY
MENTOR OH
44060-6425
US

IV. Provider business mailing address

7207 HOPKINS RD
MENTOR OH
44060-6425
US

V. Phone/Fax

Practice location:
  • Phone: 440-255-3700
  • Fax: 440-255-4375
Mailing address:
  • Phone: 440-771-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number30.022892
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number30.022892
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: