Individual provider Active NPI

Jeffrey Allen Schmunk, D.D.S.

  • Dentist
  • Mansfield, OH
National Provider Identifier
1023145513
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14985 Issued in OH
Practice address
625 Cline Ave
Mansfield, OH 44907-1038
Phone
(419) 756-1001
Fax
(419) 756-5895
NPI assigned
Feb 28, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14985 OH Primary

Addresses

Primary practice location

625 Cline Ave
Mansfield, OH 44907-1038

Mailing address

625 Cline Ave
Mansfield, OH 44907-1038
Phone (419) 756-1001

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14985OHMDPrimary Care Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023145513",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 CLINE AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071038",
            "telephone_number": "419-756-1001",
            "fax_number": "419-756-5895"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "625 CLINE AVE",
            "city": "MANSFIELD",
            "state": "OH",
            "postal_code": "449071038",
            "telephone_number": "419-756-1001",
            "fax_number": "419-756-5895"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMUNK",
        "first_name": "JEFFREY",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "14985",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mansfield, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.