Individual provider Active NPI

Frederick Arthur Schoenbrodt, DDS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Ellicott City, MD
National Provider Identifier
1912100892
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
4648 Issued in MD
Practice address
9005 Chevrolet Drive
Suite a
Ellicott City, MD 21042
Phone
(410) 465-5253
Fax
(410) 418-5830
NPI assigned
Jun 7, 2007
Sex
Male
Sole proprietor
No

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
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 4648 MD Primary

Addresses

Primary practice location

9005 Chevrolet Drive
Suite a
Ellicott City, MD 21042

Mailing address

9005 Chevrolet Drive
Suite a
Ellicott City, MD 21042
Phone (410) 465-5253

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
4648MDMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1912100892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9005 CHEVROLET DRIVE",
            "address_2": "SUITE A",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "21042",
            "telephone_number": "410-465-5253",
            "fax_number": "410-418-5830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9005 CHEVROLET DRIVE",
            "address_2": "SUITE A",
            "city": "ELLICOTT CITY",
            "state": "MD",
            "postal_code": "21042",
            "telephone_number": "410-465-5253",
            "fax_number": "410-418-5830"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHOENBRODT",
        "first_name": "FREDERICK",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "MD",
            "license": "4648",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellicott City, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.