Metro Oral & Maxillofacial

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

5391C Issued in AL

Legal business name

METRO ORAL & MAXILLOFACIAL

Practice address

100 Metro Dr
Dothan, AL 36303-1985

Phone

(334) 699-5555

NPI assigned

Mar 18, 2008

Last updated

Mar 18, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Craig D Schmidtke, DDSNPI 1467550400

Title

Oral Surgeon/Owner

Phone

(334) 699-5555

Specialties & licenses 3

Addresses

Other identifiers 3

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Craig D Schmidtke, D.D.S

  • Oral and Maxillofacial Radiology Dentistry
  • Dothan, AL
  • NPI 1467550400

  Oral and Maxillofacial Pathology

  NPD (past) Authorized official

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205798400000",
    "number": "1023289998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 METRO DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031985",
            "telephone_number": "334-699-5555"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 METRO DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031985",
            "telephone_number": "334-699-5555"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO ORAL & MAXILLOFACIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-18",
        "last_updated": "2008-03-18",
        "status": "A",
        "authorized_official_last_name": "SCHMIDTKE",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "ORAL SURGEON/OWNER",
        "authorized_official_telephone_number": "334-699-5555",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "AL",
            "license": "5391C",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AL",
            "license": "5391C",
            "primary": true
        },
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "AL",
            "license": "5391C",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF ALABAMA",
            "identifier": "51529237",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "755031",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA LICENSE #",
            "identifier": "5391C",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Dothan, AL
• Providers in Dothan, AL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2008; 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.