Individual provider Active NPI

M Paul Schafer, DDS

  • General Practice Dentistry
  • Novato, CA
National Provider Identifier
1083732499
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
42090 Issued in CA
Practice address
896 Sutro Ave
Novato, CA 94947-2040
Phone
(415) 897-9910
Fax
(415) 893-1086
NPI assigned
Mar 26, 2007
Sex
Male
Sole proprietor
Yes

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
General Practice Dentistry 1223G0001X 42090 CA Primary

Addresses

Primary practice location

896 Sutro Ave
Novato, CA 94947-2040

Mailing address

896 Sutro Ave
Novato, CA 94947-2040
Phone (415) 897-9910

Other names 1

  • Dr. Marvin Paul Schafer Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
42090CAMDLicensed Psychiatric Technician

NPI Registry JSON

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083732499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "896 SUTRO AVE",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949472040",
            "telephone_number": "415-897-9910",
            "fax_number": "415-893-1086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "896 SUTRO AVE",
            "city": "NOVATO",
            "state": "CA",
            "postal_code": "949472040",
            "telephone_number": "415-897-9910",
            "fax_number": "415-893-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAFER",
        "first_name": "M",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "42090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARVIN",
            "last_name": "SCHAFER",
            "middle_name": "PAUL",
            "prefix": "DR.",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Novato, CA

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.