Individual provider Active NPI

Frederick Joseph Schwendeman, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bozeman, MT
National Provider Identifier
1285221655
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
1952 Issued in MT
Practice address
108 N 11TH Ave Ste 4
Bozeman, MT 59715-3264
Phone
(406) 587-5435
Fax
(406) 587-9093
NPI assigned
Dec 30, 2020
Last updated
Dec 30, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 1952 MT Primary

Addresses

Primary practice location

108 N 11TH Ave Ste 4
Bozeman, MT 59715-3264

Mailing address

108 N 11TH Ave Ste 4
Bozeman, MT 59715-3264
Phone (406) 587-5435

Other identifiers 1

IdentifierTypeStateIssuer
1154484897OtherNPI, TYPE 2

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
1952MTMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Wojj Pediatric Dentistry PastSince Jan 3, 2021 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1609286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1285221655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 N 11TH AVE STE 4",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597153264",
            "telephone_number": "406-587-5435",
            "fax_number": "406-587-9093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 N 11TH AVE STE 4",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597153264",
            "telephone_number": "406-587-5435",
            "fax_number": "406-587-9093"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWENDEMAN",
        "first_name": "FREDERICK",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-30",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MT",
            "license": "1952",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI, TYPE 2",
            "identifier": "1154484897",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bozeman, MT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 30, 2020; 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.