Individual provider Active NPI

Craig Bruce Schroeder, D.D.S.

  • Dentist
  • Delray Beach, FL
National Provider Identifier
1164603916
Registry record updated Nov 21, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN13167 Issued in FL
Practice address
1045 E Atlantic Ave
Suite 304
Delray Beach, FL 33483-6955
Phone
(561) 278-0388
Fax
(561) 278-0389
NPI assigned
Nov 21, 2007
Last updated
Nov 21, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN13167 FL Primary

Addresses

Primary practice location

1045 E Atlantic Ave
Suite 304
Delray Beach, FL 33483-6955

Mailing address

1045 E Atlantic Ave
Suite 304
Delray Beach, FL 33483-6955
Phone (561) 278-0388

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
DN13167FLMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1195603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195603200000",
    "number": "1164603916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 E ATLANTIC AVE",
            "address_2": "SUITE 304",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334836955",
            "telephone_number": "561-278-0388",
            "fax_number": "561-278-0389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 E ATLANTIC AVE",
            "address_2": "SUITE 304",
            "city": "DELRAY BEACH",
            "state": "FL",
            "postal_code": "334836955",
            "telephone_number": "561-278-0388",
            "fax_number": "561-278-0389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "CRAIG",
        "middle_name": "BRUCE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-11-21",
        "last_updated": "2007-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN13167",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Delray Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 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.