Individual provider Active NPI

William Frederick Schultz Jr., DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Columbus, IN
National Provider Identifier
1104982065
Registry record updated Apr 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
12005942 Issued in IN
Practice address
2350 N Park Dr
Columbus, IN 47203-4466
Phone
(812) 372-7312
Fax
(812) 378-9451
NPI assigned
Dec 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 12005942 IN Primary

Addresses

Primary practice location

2350 N Park Dr
Columbus, IN 47203-4466

Mailing address

2350 N Park Dr
Columbus, IN 47203-4466
Phone (812) 372-7312

Other identifiers 1

IdentifierTypeStateIssuer
000000199670OtherINBCBS

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
12005942INMDOral and Maxillofacial Surgery (Dentist)

Practice roles

OrganizationSpecialtyStatusNew patients
Columbus Oral & Maxillofacial Surgery PSC Oral and Maxillofacial Surgery Past Accepting new patients

Organizations & group practices 1

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": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207785600000",
    "number": "1104982065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2350 N PARK DR",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472034466",
            "telephone_number": "812-372-7312",
            "fax_number": "812-378-9451"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2350 N PARK DR",
            "city": "COLUMBUS",
            "state": "IN",
            "postal_code": "472034466",
            "telephone_number": "812-372-7312",
            "fax_number": "812-378-9451"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTZ",
        "first_name": "WILLIAM",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2008-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "IN",
            "license": "12005942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "000000199670",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 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.