Provider Demographics
NPI:1477600013
Name:SCHUMER, J DOUGLAS (DDS)
Entity Type:Individual
Prefix:MR
First Name:J
Middle Name:DOUGLAS
Last Name:SCHUMER
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 1:6878 ERIE ROAD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:DERBY
Mailing Address - State:NY
Mailing Address - Zip Code:14047-9508
Mailing Address - Country:US
Mailing Address - Phone:716-947-4652
Mailing Address - Fax:716-947-5758
Practice Address - Street 1:6878 ERIE ROAD
Practice Address - Street 2:SUITE 5
Practice Address - City:DERBY
Practice Address - State:NY
Practice Address - Zip Code:14047-9508
Practice Address - Country:US
Practice Address - Phone:716-947-4652
Practice Address - Fax:716-947-5758
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-05
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0329821223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice