Provider Demographics
NPI:1225694672
Name:SCHROEDER, BYRON MATTHEW (DDS)
Entity type:Individual
Prefix:DR
First Name:BYRON
Middle Name:MATTHEW
Last Name:SCHROEDER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9840 E 81ST ST STE 100
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-4583
Mailing Address - Country:US
Mailing Address - Phone:918-273-6609
Mailing Address - Fax:
Practice Address - Street 1:9840 E 81ST ST STE 100
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74133-4583
Practice Address - Country:US
Practice Address - Phone:918-273-6609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-10
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7826122300000X
OK2691223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty
No122300000XDental ProvidersDentist