Individual provider Active NPI

Stephen Robert Schacht, D.D.S.

  • Dentist
  • West Bend, WI
National Provider Identifier
1942238274
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
5002114-015 Issued in WI
Practice address
1201 Oak St
West Bend, WI 53095-3800
Phone
(262) 334-5151
NPI assigned
Jun 28, 2006
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
Dentist 122300000X 5002114-015 WI Primary

Addresses

Primary practice location

1201 Oak St
West Bend, WI 53095-3800

Mailing address

126 Laurel Dr S
West Bend, WI 53095-5006
Phone (262) 335-1874

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20160112001011 WI Order and Referring Only - DentistPractitioner - Dentist 6800198524

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5002114-015WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1151452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942238274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 LAUREL DR S",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530955006",
            "telephone_number": "262-335-1874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 OAK ST",
            "city": "WEST BEND",
            "state": "WI",
            "postal_code": "530953800",
            "telephone_number": "262-334-5151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHACHT",
        "first_name": "STEPHEN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "5002114-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Bend, WI

Sources for this page

Verify at the official NPI Registry.