Individual provider Active NPI

Stephen H Schwab, DDS

  • General Practice Dentistry
  • Syracuse, NY
National Provider Identifier
1255347886
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
034806 Issued in NY
Practice address
1638 W Genesee St
Syracuse, NY 13204-1952
Phone
(315) 468-4100
Fax
(315) 468-5885
NPI assigned
Aug 1, 2006
Sex
Male
Sole proprietor
Yes

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 034806 NY Primary

Addresses

Primary practice location

1638 W Genesee St
Syracuse, NY 13204-1952

Mailing address

1638 W Genesee St
Syracuse, NY 13204-1952
Phone (315) 468-4100

Other identifiers 1

IdentifierTypeStateIssuer
00631118MedicaidNY

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
034806NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Palma and Nardozza Dental Services General Practice PastSince Jul 17, 2022 Accepting new patients
Dental Arts Group Past Accepting new patients

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": "1154390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1255347886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1638 W GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132041952",
            "telephone_number": "315-468-4100",
            "fax_number": "315-468-5885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1638 W GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132041952",
            "telephone_number": "315-468-4100",
            "fax_number": "315-468-5885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWAB",
        "first_name": "STEPHEN",
        "middle_name": "H",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "034806",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00631118",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Syracuse, NY

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.