Provider Demographics
NPI:1386720316
Name:SCHMIDT, ROBERT CARL (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CARL
Last Name:SCHMIDT
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 1:13400 VAN AKEN BLVD.
Mailing Address - Street 2:304
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44120
Mailing Address - Country:US
Mailing Address - Phone:216-577-8171
Mailing Address - Fax:216-577-8171
Practice Address - Street 1:8200 AVERY RD
Practice Address - Street 2:
Practice Address - City:BROADVIEW HTS
Practice Address - State:OH
Practice Address - Zip Code:44147-1650
Practice Address - Country:US
Practice Address - Phone:440-526-4866
Practice Address - Fax:440-526-9204
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300200781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice