Individual provider Active NPI

Elyse Marie Schulte, D.D.S.

  • General Practice Dentistry
  • Mason, OH
National Provider Identifier
1790104255
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
30.024181 Issued in OH
Practice address
5841 Snider Rd
Mason, OH 45040
Phone
(513) 777-9117
Fax
(513) 777-9111
NPI assigned
Apr 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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 30.024181 OH Primary

Addresses

Primary practice location

5841 Snider Rd
Mason, OH 45040

Mailing address

5841 Snider Rd
Mason, OH 45040
Phone (513) 777-9117

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
I20170921001033 OH Order and Referring Only - DentistPractitioner - Dentist 6507130044

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.024181OHMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Elyse M Schulte DDS LLC CurrentSince Aug 29, 2021 Accepting new patients
Afinia Dental - Killgore & Shaftel Inc. General Practice Past Accepting new patients

Locations

6518 Winford Ave
Fairfield Township, OH 45011
Phone (513) 712-9642

Organizations & group practices 2

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": "1397433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1790104255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5841 SNIDER RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "45040",
            "telephone_number": "513-777-9117",
            "fax_number": "513-777-9111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5841 SNIDER RD",
            "city": "MASON",
            "state": "OH",
            "postal_code": "45040",
            "telephone_number": "513-777-9117",
            "fax_number": "513-777-9111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHULTE",
        "first_name": "ELYSE",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-14",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30.024181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mason, OH

Sources for this page

Verify at the official NPI Registry.