Individual provider Active NPI

Scott Vassel Schlofman, DDS

  • Endodontics
  • Fort Sam Houston, TX
National Provider Identifier
1114901261
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
31409 Issued in TX
Practice address
2940 Stanley Rd
Fort Sam Houston, TX 78234-2740
Phone
(210) 295-4095
NPI assigned
Dec 2, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 31409 TX
Dentist 122300000X D-3906 ID
Endodontics 1223E0200X D-3906 ID
Endodontics 1223E0200X 31409 TX Primary

Addresses

Primary practice location

2940 Stanley Rd
Fort Sam Houston, TX 78234-2740

Mailing address

4070 Stanley Rd Ste 214
Fort Sam Houston, TX 78234-2714
Phone (210) 295-2368

Other practice location 1

3145 Garden Ave Ste 1278
Fort Sam Houston, TX 78234-7719
Phone (210) 808-3735

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
D-3906IDMDDentist
31409TXMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1133481600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1114901261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4070 STANLEY RD STE 214",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782342714",
            "telephone_number": "210-295-2368"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2940 STANLEY RD",
            "city": "FORT SAM HOUSTON",
            "state": "TX",
            "postal_code": "782342740",
            "telephone_number": "210-295-4095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3145 Garden Ave Ste 1278",
            "address_purpose": "LOCATION",
            "city": "Fort Sam Houston",
            "state": "TX",
            "postal_code": "782347719",
            "country_code": "US",
            "telephone_number": "210-808-3735",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHLOFMAN",
        "first_name": "SCOTT",
        "middle_name": "VASSEL",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-02",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "31409",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-3906",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "ID",
            "license": "D-3906",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "31409",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Sam Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; 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.