Individual provider Active NPI

Todd Michael Schroeder, DDS

  • Public Health Dentistry
  • Milton Freewater, OR
National Provider Identifier
1639291008
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
8170 Issued in OR
Practice address
13 NE 5TH Ave
Milton Freewater, OR 97862-1701
Phone
(541) 938-0400
Fax
(541) 938-0440
NPI assigned
Apr 4, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X 8170 OR Primary

Addresses

Primary practice location

13 NE 5TH Ave
Milton Freewater, OR 97862-1701

Mailing address

80344 Steen Rd
Milton Freewater, OR 97862-7314
Phone (509) 386-7940

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150713001158 OR Order and Referring Only - DentistPractitioner - Dentist 0143532630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8170ORMDPublic Health Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Todd Schroeder DDS PC Dental Public Health CurrentSince May 14, 2014 Accepting new patients

Locations

13 NE 5th Ave
Milton Freewater, OR 97862
Phone (541) 938-0400

Organizations & group practices 1

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": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1639291008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80344 STEEN RD",
            "city": "MILTON FREEWATER",
            "state": "OR",
            "postal_code": "978627314",
            "telephone_number": "509-386-7940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 NE 5TH AVE",
            "city": "MILTON FREEWATER",
            "state": "OR",
            "postal_code": "978621701",
            "telephone_number": "541-938-0400",
            "fax_number": "541-938-0440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHROEDER",
        "first_name": "TODD",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "OR",
            "license": "8170",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton Freewater, OR

Sources for this page

Verify at the official NPI Registry.