Provider Demographics
NPI:1528057601
Name:SCHOENBAUM, RICHARD PETER (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:PETER
Last Name:SCHOENBAUM
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 1:4383 OVERLAND AVE
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-4129
Mailing Address - Country:US
Mailing Address - Phone:310-837-2417
Mailing Address - Fax:310-838-5360
Practice Address - Street 1:4383 OVERLAND AVE
Practice Address - Street 2:
Practice Address - City:CULVER CITY
Practice Address - State:CA
Practice Address - Zip Code:90230-4129
Practice Address - Country:US
Practice Address - Phone:310-837-2417
Practice Address - Fax:310-838-5360
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA227061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice