Provider Demographics
NPI:1427154046
Name:SCHMIDT, DANIEL LEE (DDS)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:LEE
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 1:1100 N MAIN STREET
Mailing Address - Street 2:SUITE 101
Mailing Address - City:AUBURN
Mailing Address - State:IN
Mailing Address - Zip Code:46706-1200
Mailing Address - Country:US
Mailing Address - Phone:260-925-3110
Mailing Address - Fax:260-925-5690
Practice Address - Street 1:1100 N MAIN STREET
Practice Address - Street 2:SUITE 101
Practice Address - City:AUBURN
Practice Address - State:IN
Practice Address - Zip Code:46706-1200
Practice Address - Country:US
Practice Address - Phone:260-925-3110
Practice Address - Fax:260-925-5690
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN7380122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
695967OtherUNITED CONCORDIA