Aaron Micheal Schamback, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN15739 Issued in FL

Practice address

1949 SE Port St Lucie Blvd
Port St Lucie, FL 34952-5535

Phone

(772) 398-0990

Fax

(772) 398-0939

NPI assigned

Jan 2, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jun 26, 2019 through Jun 26, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aaron Schamback, DMD, PA

  dba Great Smile Dental

  • General Practice Dentistry
  • Port Saint Lucie, FL
  • NPI 1033680830
  NPD (past) Authorized official
• Great Smile Dental Pediatrics

  • Pediatric Dentistry
  • Port St Lucie, FL
  • NPI 1669335212
  Authorized official Same address or phone

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

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528125358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1949 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525535",
            "telephone_number": "772-398-0990",
            "fax_number": "772-398-0939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1949 SE PORT ST LUCIE BLVD",
            "city": "PORT ST LUCIE",
            "state": "FL",
            "postal_code": "349525535",
            "telephone_number": "772-398-0990",
            "fax_number": "772-398-0939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHAMBACK",
        "first_name": "AARON",
        "middle_name": "MICHEAL",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN15739",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Savorah Alf II
• Prithvi Raj Sawh, M.D.
• Sage Scales, PHARMD
• Nancy Scarpetta
• Rochelle Scavella, RRT
• Edward J Scheel, MD
• Lynn A. Scheel, M.D.
• Luz Schelmety-Henriquez, ARNP, BC
• Kelly Schmader
• Hannah Marie Schmidt

• General Practice Dentistry in Port St Lucie, FL
• Providers in Port St Lucie, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.