Healthcare Provider Details

I. General information

NPI: 1598186470
Provider Name (Legal Business Name): JOHN M SCHIEFELBEIN, DMD, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2013
Last Update Date: 12/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

246 DIVISION ST
LEAVENWORTH WA
98826-1426
US

IV. Provider business mailing address

PO BOX 787
LEAVENWORTH WA
98826-0787
US

V. Phone/Fax

Practice location:
  • Phone: 509-548-5841
  • Fax: 509-548-1064
Mailing address:
  • Phone: 509-548-5841
  • Fax: 509-548-1064

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN SCHIEFELBEIN
Title or Position: MEMBER MANAGER/DENTIST
Credential: DMD
Phone: 509-548-5841