Mary Kay Schwab, DMD, FAGD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D6507 Issued in OR

Practice address

620 SW 5TH Ave
Suite 1006
Portland, OR 97204-1428

Phone

(503) 228-1470

Fax

(503) 229-4907

NPI assigned

Jul 18, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

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 OR

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": "1153180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619996170",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 SW 5TH AVE",
            "address_2": "SUITE 1006",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041428",
            "telephone_number": "503-228-1470",
            "fax_number": "503-229-4907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 SW 5TH AVE",
            "address_2": "SUITE 1006",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972041428",
            "telephone_number": "503-228-1470",
            "fax_number": "503-229-4907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHWAB",
        "first_name": "MARY",
        "middle_name": "KAY",
        "name_prefix": "Dr.",
        "credential": "DMD, FAGD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D6507",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gretchen Campbell Schwab
• Holly Schwab, DPT
• Jonathan Lee Schwab, M.D.
• Kathryn Marie Schwab, MPH, RD
• Lindsey Marie Schwab, M.S., CF-SLP
• Pascale M Schwab, M.D.
• Renee Christine Schwab
• Sarah Jane Schwab, RPH
• Tara Ann Schwab, M.D.
• Andrew Schwager

• General Practice Dentistry in Portland, OR
• Providers in Portland, OR by specialty
• General Practice Dentistry in Oregon

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.