Individual provider Active NPI

Jerome R Schmidt, DDS

  • General Practice Dentistry
  • Endwell, NY
National Provider Identifier
1134189145
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
50029736 Issued in NY
Practice address
515 Alfred Dr
Endwell, NY 13760-2333
Phone
(607) 754-3080
NPI assigned
Mar 24, 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 50029736 NY Primary

Addresses

Primary practice location

515 Alfred Dr
Endwell, NY 13760-2333

Mailing address

515 Alfred Dr
Endwell, NY 13760-2333
Phone (607) 754-3080

Other identifiers 1

IdentifierTypeStateIssuer
00613887MedicaidNY

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
50029736NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1143158400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1134189145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 ALFRED DR",
            "city": "ENDWELL",
            "state": "NY",
            "postal_code": "137602333",
            "telephone_number": "607-754-3080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 ALFRED DR",
            "city": "ENDWELL",
            "state": "NY",
            "postal_code": "137602333",
            "telephone_number": "607-754-3080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "JEROME",
        "middle_name": "R",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "50029736",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00613887",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Endwell, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.