Provider Demographics
NPI:1114338985
Name:SCHNIPKE, SHANA (DDS)
Entity Type:Individual
Prefix:
First Name:SHANA
Middle Name:
Last Name:SCHNIPKE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS GROVE
Mailing Address - State:OH
Mailing Address - Zip Code:45830
Mailing Address - Country:US
Mailing Address - Phone:410-659-6000
Mailing Address - Fax:
Practice Address - Street 1:109 N HIGH ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS GROVE
Practice Address - State:OH
Practice Address - Zip Code:45830-1240
Practice Address - Country:US
Practice Address - Phone:410-659-6000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-15
Last Update Date:2014-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-0242031223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice