Provider Demographics
NPI:1275863292
Name:SCHOENGOLD, JEFFREY B (DDS)
Entity Type:Individual
Prefix:MR
First Name:JEFFREY
Middle Name:B
Last Name:SCHOENGOLD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:435 NORTH ST
Mailing Address - Street 2:JEFFREY B.SCHOENGOLD DDS
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605
Mailing Address - Country:US
Mailing Address - Phone:914-328-0071
Mailing Address - Fax:914-358-1326
Practice Address - Street 1:435 NORTH STREET
Practice Address - Street 2:1
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-2230
Practice Address - Country:US
Practice Address - Phone:914-328-0071
Practice Address - Fax:914-358-1326
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-14
Last Update Date:2010-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY036245122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist