Provider Demographics
NPI:1295854602
Name:SCHMID, JOHN STUART (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:STUART
Last Name:SCHMID
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 1:3355 BEE CAVE RD
Mailing Address - Street 2:STE 201
Mailing Address - City:WEST LAKE HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78746-6775
Mailing Address - Country:US
Mailing Address - Phone:512-329-5967
Mailing Address - Fax:512-327-5902
Practice Address - Street 1:3355 BEE CAVE RD
Practice Address - Street 2:STE 201
Practice Address - City:WEST LAKE HILLS
Practice Address - State:TX
Practice Address - Zip Code:78746-6775
Practice Address - Country:US
Practice Address - Phone:512-329-5967
Practice Address - Fax:512-327-5902
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDS-17302122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist