Active NPI
Matthew Schnettler, DDS
- Dentist
- Chicago, IL
National Provider Identifier
1356828842
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 019031791
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019031791 | Other | IL | STATE LICENSE |
| 319021145 | Other | IL | CDS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 019031791 | IL | MD | Dentist |
| 019.031791 | IL | MD | General Practice Dentistry |
Interoperability endpoints
- 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.