Charles Joseph Schildroth Jr., DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN011910 Issued in FL

Practice address

5120 Bayou Blvd
Ste.4
Pensacola, FL 32503-2193

Phone

(850) 477-3188

Fax

(850) 477-6776

NPI assigned

Jan 22, 2007

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

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in FL

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

State licenses

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1740334655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5120 BAYOU BLVD",
            "address_2": "STE.4",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032193",
            "telephone_number": "850-477-3188",
            "fax_number": "850-477-6776"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 BAYOU BLVD",
            "address_2": "STE.4",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032193",
            "telephone_number": "850-477-3188",
            "fax_number": "850-477-6776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHILDROTH",
        "first_name": "CHARLES",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN011910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "9830",
            "identifier": "SAFEGUARD",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "25852",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "109808",
            "identifier": "AETNA",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "995573",
            "identifier": "COMPBENEFITS",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "724127",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michaela Cassie Aneicia Scheibe, RBT
• Michaela Nicole Scheidler
• Jennifer L. Schellenberg
• Jeremy Steven Scherer, DO
• Scott G Scheurich, DMD, PA
• Michelle Schilling, MPH
• Dawn Janan Schindler
• Erin C Schlechter, APRN
• Joseph Scott Schlesinger, O.D.
• Cassia Fernanda Schmid

• General Practice Dentistry in Pensacola, FL
• Providers in Pensacola, 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 Jun 1, 2016; 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.