MEDICARE: STEVEN JOHN SCHEFFEL D.M.D.

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	1223G0001X	General Practice Dentistry	D6366	OR

General Provider Information

NPI Number	:	1538160973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN JOHN SCHEFFEL D.M.D.

Provider Business Mailing Address
First Line	:	5415 SW WESTGATE DR
Second Line	:	STE. 206
City	:	PORTLAND
State	:	OR
Zip	:	97221-2409
Country	:	US
Telephone Number	:	503-292-1173
Fax Number	:	503-291-0353

Provider Business Practice Location Address
First Line	:	5415 SW WESTGATE DR
Second Line	:	STE. 206
City	:	PORTLAND
State	:	OR
Zip	:	97221-2409
Country	:	US
Telephone Number	:	503-292-1173
Fax Number	:	503-291-0353

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	07/08/2007

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