Individual provider Active NPI

Mark David Scheiderich, DMD PA

  • General Practice Dentistry
  • Fletcher, NC
National Provider Identifier
1174662365
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
NC8028 Issued in NC
Practice address
20 Cane Creek Rd
Fletcher, NC 28732-9707
Phone
(828) 684-5888
Fax
(828) 684-1093
NPI assigned
Feb 5, 2007
Sex
Male
Sole proprietor
No

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 NC8028 NC Primary

Addresses

Primary practice location

20 Cane Creek Rd
Fletcher, NC 28732-9707

Mailing address

20 Cane Creek Rd
Fletcher, NC 28732-9707
Phone (828) 684-5888

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
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
NC8028NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Scheiderich and Kuyk, PLLC General Practice CurrentSince Sep 23, 2024 Accepting new patients
Dr Mark D Scheiderich DMD PA General Practice Past Accepting new patients

Locations

20 Cane Creek Rd
Fletcher, NC 28732
Phone (828) 684-5888

Organizations & group practices 2

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": "1170633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174662365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CANE CREEK RD",
            "city": "FLETCHER",
            "state": "NC",
            "postal_code": "287329707",
            "telephone_number": "828-684-5888",
            "fax_number": "828-684-1093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CANE CREEK RD",
            "city": "FLETCHER",
            "state": "NC",
            "postal_code": "287329707",
            "telephone_number": "828-684-5888",
            "fax_number": "828-684-1093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHEIDERICH",
        "first_name": "MARK",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "DMD PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "NC8028",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fletcher, NC

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.