Individual provider Active NPI

Amy Schimschock, DMD

  • General Practice Dentistry
  • Salem, OR
National Provider Identifier
1922585041
Registry record updated Jun 25, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D11605 Issued in OR
Practice address
1920 Turner Rd SE Ste B
Salem, OR 97302
Phone
(971) 718-5358
Fax
(541) 516-4053
NPI assigned
Jul 21, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 25, 2022

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 D11605 OR Primary

Addresses

Primary practice location

1920 Turner Rd SE Ste B
Salem, OR 97302

Mailing address

1920 Turner Rd SE
Suite B
Salem, OR 97302
Phone (971) 718-5358

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
D11605ORMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Callaway-Nelson Lemmon Valley Dental Group PC General Practice Past 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1532131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656115200000",
    "number": "1922585041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1920 TURNER RD SE",
            "address_2": "SUITE B",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97302",
            "telephone_number": "971-718-5358",
            "fax_number": "541-516-4053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1920 TURNER RD SE STE B",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "97302",
            "telephone_number": "971-718-5358",
            "fax_number": "541-516-4053"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHIMSCHOCK",
        "first_name": "AMY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-21",
        "last_updated": "2022-06-25",
        "certification_date": "2022-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "OR",
            "license": "D11605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2022; 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.