Individual provider Active NPI

Matthew Schnettler, DDS

  • Dentist
  • Chicago, IL
National Provider Identifier
1356828842
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
019031791 Issued in IL
Practice address
3750 W Ogden Ave
Chicago, IL 60623-2426
Phone
(872) 588-3220
NPI assigned
Jul 26, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 019.031791 IL
Dentist 122300000X 019031791 IL Primary

Addresses

Primary practice location

3750 W Ogden Ave
Chicago, IL 60623-2426

Mailing address

353 N Desplaines St Apt 1802
Chicago, IL 60661-1351

Other identifiers 2

IdentifierTypeStateIssuer
019031791OtherILSTATE LICENSE
319021145OtherILCDS

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
019031791ILMDDentist
019.031791ILMDGeneral Practice Dentistry

Interoperability endpoints

  • Direct secure messaging: mschnettler691066@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1356828842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 N DESPLAINES ST APT 1802",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606611351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3750 W OGDEN AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606232426",
            "telephone_number": "872-588-3220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHNETTLER",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-26",
        "last_updated": "2023-03-07",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.031791",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019031791",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "019031791",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDS",
            "identifier": "319021145",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.