Individual provider Active NPI

Jeffrey S Schroeder, DDS

  • General Practice Dentistry
  • West Richland, WA
National Provider Identifier
1073556940
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
6932 Issued in WA
Practice address
4476 W Van Giesen St
West Richland, WA 99353-5411
Phone
(509) 967-3421
Fax
(509) 967-2186
NPI assigned
Jun 14, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 6932 WA Primary

Addresses

Primary practice location

4476 W Van Giesen St
West Richland, WA 99353-5411

Mailing address

4476 W Van Giesen St
West Richland, WA 99353-5411
Phone (509) 967-3421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GU
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160803001750 GU Order and Referring Only - DentistPractitioner - Dentist 0941594675

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6932WAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Madsen, Maxfield, Karlson, Clements, McManamon, PLLC General Practice Past Accepting new patients
Penttila Schroeder Maxfield,DDS, PS General Practice Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1073556940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4476 W VAN GIESEN ST",
            "city": "WEST RICHLAND",
            "state": "WA",
            "postal_code": "993535411",
            "telephone_number": "509-967-3421",
            "fax_number": "509-967-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4476 W VAN GIESEN ST",
            "city": "WEST RICHLAND",
            "state": "WA",
            "postal_code": "993535411",
            "telephone_number": "509-967-3421",
            "fax_number": "509-967-2186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "JEFFREY",
        "middle_name": "S",
        "name_prefix": "Prof.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "6932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Richland, WA

Sources for this page

Verify at the official NPI Registry.