Healthcare Provider Details

I. General information

NPI: 1235308537
Provider Name (Legal Business Name): JOAN C. SCHMITT DDS,MSD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2008
Last Update Date: 11/28/2021
Certification Date: 11/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5366 ESTATE OFFICE DR
MEMPHIS TN
38119-0611
US

IV. Provider business mailing address

5366 ESTATE OFFICE DR STE 2
MEMPHIS TN
38119-0611
US

V. Phone/Fax

Practice location:
  • Phone: 901-682-1501
  • Fax:
Mailing address:
  • Phone: 901-682-1501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License NumberDS004431
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number12074
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: