Brian Otto Schoenrock, DDS

Primary specialty

DentistTaxonomy code 122300000X

Practice address

9600 W Buckhill Rd
Galena, IL 61036-8941

Phone

(815) 777-0604

NPI assigned

Apr 4, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207267200000",
    "number": "1407029960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9600 W BUCKHILL RD",
            "city": "GALENA",
            "state": "IL",
            "postal_code": "610368941",
            "telephone_number": "815-777-0604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9600 W BUCKHILL RD",
            "city": "GALENA",
            "state": "IL",
            "postal_code": "610368941",
            "telephone_number": "815-777-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOENROCK",
        "first_name": "BRIAN",
        "middle_name": "OTTO",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-04",
        "last_updated": "2008-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Ann Rosenthal, D.C.
• Judith R Rowett, LISW, LCSW
• Scott Richard Schaber, P.T.
• Kenneth L Schiffman, M.D.
• Erin Schoenhard, PT, DPT
• Danielle Seegmiller, ARNP
• Heather Shimkus, PHARMD
• Kim Shird
• Kori Levos Skidmore, PH.D.
• Ashley Susan Skrocki, CRNA

• Dentist in Galena, IL
• Providers in Galena, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.