Individual provider Active NPI

Peggy Crema Schomaker, D.D.S.

  • General Practice Dentistry
  • Fairfield, OH
National Provider Identifier
1639382658
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30016796 Issued in OH
Practice address
3174 Mack Rd
Suite 5
Fairfield, OH 45014-5370
Phone
(513) 874-8636
NPI assigned
May 7, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 30016796 OH Primary

Addresses

Primary practice location

3174 Mack Rd
Suite 5
Fairfield, OH 45014-5370

Mailing address

3174 Mack Rd
Suite 5
Fairfield, OH 45014-5370

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20150729007727 OH Practitioner - Dentist 9335453703 Practice locations: Fairfield, OH

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30016796OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Afinia Dental-Killgore Fairfield Inc General Practice PastSince Oct 4, 2020 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1178496000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1639382658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3174 MACK RD",
            "address_2": "SUITE 5",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3174 MACK RD",
            "address_2": "SUITE 5",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145370",
            "telephone_number": "513-874-8636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOMAKER",
        "first_name": "PEGGY",
        "middle_name": "CREMA",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30016796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.