Individual provider Active NPI

Christian David Schmidt, D.D.S.

  • Dentist
  • Los Angeles, CA
National Provider Identifier
1316296999
Registry record updated Sep 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
61757 Issued in CA
Practice address
5367 San Vicente Blvd
Apt 249
Los Angeles, CA 90019
Phone
(925) 319-7236
NPI assigned
Aug 29, 2012
Last updated
Sep 7, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 61757 CA Primary

Addresses

Primary practice location

5367 San Vicente Blvd
Apt 249
Los Angeles, CA 90019

Mailing address

5367 San Vicente Blvd
Apt 249
Los Angeles, CA 90019
Phone (925) 319-7236

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150812006201 CA Order and Referring Only - DentistPractitioner - Dentist 7517272149

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61757CAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1346198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346976000000",
    "number": "1316296999",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5367 SAN VICENTE BLVD",
            "address_2": "APT 249",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90019",
            "telephone_number": "925-319-7236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5367 SAN VICENTE BLVD",
            "address_2": "APT 249",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90019",
            "telephone_number": "925-319-7236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDT",
        "first_name": "CHRISTIAN",
        "middle_name": "DAVID",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-29",
        "last_updated": "2012-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "61757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

Verify at the official NPI Registry.