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General NPI Number Information
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NPI Number | 1639793870
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Entity Type | Individual
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Provider Name | BRYAN SCHMIDT DDS
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Gender | Male
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Dates
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Enumeration Date | 06/03/2020
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Last Update Date | 04/04/2025
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Provider Practice Location Address
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Address Line | 3901 W STATE ROAD 47 STE 24
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City | SHERIDAN
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State | IN
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Zip | 46069-9256
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Country | US
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Telephone | 317-758-5334
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Fax |
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Provider Business Mailing Address
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Address Line | 322 ALVOR CT
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City | CICERO
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State | IN
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Zip | 46034-0069
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Country | US
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Telephone | 765-603-9510
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 12013349A
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License Number State | IN
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