Individual provider Active NPI

Eric Leo Schiffman, DDS, MS

  • Orofacial Pain Dentistry
  • Saint Paul, MN
National Provider Identifier
1417021619
Registry record updated Oct 2, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orofacial Pain DentistryTaxonomy code 1223X2210X
License
D9513 Issued in MN
Practice address
2550 University Ave W
Suite 189S
Saint Paul, MN 55114-1052
Phone
(651) 332-7474
Fax
(651) 337-7475
NPI assigned
Nov 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X D9513 MN
Orofacial Pain Dentistry 1223X2210X D9513 MN Primary

Addresses

Primary practice location

2550 University Ave W
Suite 189S
Saint Paul, MN 55114-1052

Mailing address

2550 University Ave W
Suite 189S
Saint Paul, MN 55114-1052
Phone (651) 332-7474

Other identifiers 4

IdentifierTypeStateIssuer
805320100MedicaidMN
3D805SCOtherMNBLUE CROSS
37604OtherMNPREFERRED ONE
43-41030OtherMNMEDICA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN
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
I20100327000444 MN Practitioner - Oral Surgery 9436120367 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
D9513MNMDDentist
9513MNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Minnesota Head and Neck Pain Clinic, PA CurrentSince Dec 8, 1988 Accepting new patients
Minnesota Head and Neck Pain Clinic, PA CurrentSince Dec 8, 1988 Accepting new patients

Locations

3475 Plymouth Blvd
Ste 200
Plymouth, MN 55447
Phone (763) 577-2484

2550 University Ave W
Ste 189S
Saint Paul, MN 55114
Phone (651) 332-7474

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1417021619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W",
            "address_2": "SUITE 189S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141052",
            "telephone_number": "651-332-7474",
            "fax_number": "651-337-7475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W",
            "address_2": "SUITE 189S",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141052",
            "telephone_number": "651-332-7474",
            "fax_number": "651-337-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHIFFMAN",
        "first_name": "ERIC",
        "middle_name": "LEO",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-20",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D9513",
            "primary": false
        },
        {
            "code": "1223X2210X",
            "taxonomy_group": "",
            "desc": "Dentist, Orofacial Pain",
            "state": "MN",
            "license": "D9513",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805320100",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3D805SC",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED ONE",
            "identifier": "37604",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICA",
            "identifier": "43-41030",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

Verify at the official NPI Registry.