Provider Demographics
NPI:1346509338
Name:SCHWARTZ, SCOTT BRIAN (DDS, MPH)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:BRIAN
Last Name:SCHWARTZ
Suffix:
Gender:M
Credentials:DDS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3333 BURNET AVE
Mailing Address - Street 2:ML 2006
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3026
Mailing Address - Country:US
Mailing Address - Phone:513-636-4641
Mailing Address - Fax:513-636-8283
Practice Address - Street 1:3333 BURNET AVE
Practice Address - Street 2:ML 2006
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229
Practice Address - Country:US
Practice Address - Phone:513-636-4641
Practice Address - Fax:513-636-8283
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-10
Last Update Date:2018-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0237871223P0221X, 1223G0001X
OHIN PROCESS390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program