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General NPI Number Information
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NPI Number | 1689403370
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Entity Type | Organization
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Legal Business Name | SCHMIDT FAMILY DENTISTRY LLC
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Dates
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Enumeration Date | 07/30/2024
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Last Update Date | 04/25/2025
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Provider Practice Location Address
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Address Line | 3901 IN 47 SUITE 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 | OWNER/DENTIST
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Name | DR. BRYAN SCHMIDT
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Credential | DDS
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Telephone | 765-603-9510
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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