MEDICARE: JEFFREY J SCHROEDER, DDS PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist

General Provider Information

NPI Number	:	1184890527
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JEFFREY J SCHROEDER, DDS PC

Provider Business Mailing Address
First Line	:	841 N 98TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68114-2338
Country	:	US
Telephone Number	:	402-934-5397
Fax Number	:	402-933-1286

Provider Business Practice Location Address
First Line	:	841 N 98TH ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68114-2338
Country	:	US
Telephone Number	:	402-934-5397
Fax Number	:	402-933-1286

Authorized Official
Title or Position	:	OWNER
Name	:	DR. JEFFREY J SCHROEDER
Credential	:	DDS
Telephone Number	:	402-934-5397

Provider Enumeration Date	:	05/06/2008
Last Update Date	:	11/30/2015

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