Individual provider Active NPI

Benjamin Schremp, DDS

  • General Practice Dentistry
  • Perryville, MO
National Provider Identifier
1639662836
Registry record updated Jun 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2018017604 Issued in MO
Practice address
12 S Jackson St
Perryville, MO 63775-2515
Phone
(573) 547-5570
NPI assigned
Jun 12, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2018

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 2018017604 MO Primary

Addresses

Primary practice location

12 S Jackson St
Perryville, MO 63775-2515

Mailing address

12 S Jackson St
Perryville, MO 63775-2515
Phone (573) 547-5570

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2018017604MOMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Schremp Family Dentistry LLC CurrentSince Sep 25, 2022 Accepting new patients

Locations

12 S Jackson St
Perryville, MO 63775
Phone (573) 547-5570

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": "1528761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528761600000",
    "number": "1639662836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12 S JACKSON ST",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637752515",
            "telephone_number": "573-547-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 S JACKSON ST",
            "city": "PERRYVILLE",
            "state": "MO",
            "postal_code": "637752515",
            "telephone_number": "573-547-5570"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHREMP",
        "first_name": "BENJAMIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-12",
        "last_updated": "2018-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2018017604",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Perryville, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.