Provider Demographics
NPI:1013558576
Name:SCHNEIDER, JASMINE (DMD)
Entity Type:Individual
Prefix:
First Name:JASMINE
Middle Name:
Last Name:SCHNEIDER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 EDWIN DRIVE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-4525
Mailing Address - Country:US
Mailing Address - Phone:757-499-2100
Mailing Address - Fax:
Practice Address - Street 1:7923 HALPRIN DR
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23518-3005
Practice Address - Country:US
Practice Address - Phone:757-587-0874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-04
Last Update Date:2019-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401416717122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist