Provider Demographics
NPI:1265500367
Name:SCHAEFER, JAMES JEFFREY (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:JEFFREY
Last Name:SCHAEFER
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 1:9670 E WASHINGTON ST
Mailing Address - Street 2:STE 135
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46229-3038
Mailing Address - Country:US
Mailing Address - Phone:317-357-3533
Mailing Address - Fax:317-357-3565
Practice Address - Street 1:9670 E WASHINGTON ST
Practice Address - Street 2:STE 135
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46229-3038
Practice Address - Country:US
Practice Address - Phone:317-357-3533
Practice Address - Fax:317-357-3565
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN86131223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice