Individual provider Active NPI

Craig D Schmidtke, D.D.S

  • Oral and Maxillofacial Radiology Dentistry
  • Dothan, AL
National Provider Identifier
1467550400
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Radiology DentistryTaxonomy code 1223X0008X
License
5391C Issued in AL
Practice address
100 Metro Dr
Dothan, AL 36303-1985
Phone
(334) 699-5555
Fax
(334) 699-5558
NPI assigned
Sep 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Pathology Dentistry 1223P0106X 5391C AL
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 5391C AL
Oral and Maxillofacial Radiology Dentistry 1223X0008X 5391C AL Primary

Addresses

Primary practice location

100 Metro Dr
Dothan, AL 36303-1985

Mailing address

100 Metro Dr
Dothan, AL 36303-1985
Phone (334) 699-5555

Other identifiers 3

IdentifierTypeStateIssuer
51529237OtherALBCBS OF AL PROVIDER #I
5391COtherALALABAMA LICENSE #
755031OtherALUNITED CONCORDIA PROVI #

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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
I20140729001414 AL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 6709853021

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5391CALMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Metro Oral & Maxillofacial Oral and Maxillofacial Pathology Past Accepting new patients
Vail Valley Oral and Maxillofacial Surgery, Professional L.L.C. Oral and Maxillofacial Surgery Past Accepting new patients
Al Dothan Dental Professionals PC Oral and Maxillofacial Surgery PastSince Oct 27, 2019 Accepting new patients

Organizations & group practices 3

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": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1467550400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 METRO DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031985",
            "telephone_number": "334-699-5555",
            "fax_number": "334-699-5558"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 METRO DR",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363031985",
            "telephone_number": "334-699-5555",
            "fax_number": "334-699-5558"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHMIDTKE",
        "first_name": "CRAIG",
        "middle_name": "D",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0106X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Pathology",
            "state": "AL",
            "license": "5391C",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "AL",
            "license": "5391C",
            "primary": false
        },
        {
            "code": "1223X0008X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Radiology",
            "state": "AL",
            "license": "5391C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF AL PROVIDER #I",
            "identifier": "51529237",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALABAMA LICENSE #",
            "identifier": "5391C",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVI #",
            "identifier": "755031",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dothan, AL

Sources for this page

Verify at the official NPI Registry.