Provider Demographics
NPI:1477814408
Name:SCHROEDER, STEPHEN NICHOLAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:NICHOLAS
Last Name:SCHROEDER
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 1:114 VIRGINIA ST
Mailing Address - Street 2:APARTMENT #311
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23219-4124
Mailing Address - Country:US
Mailing Address - Phone:434-222-6656
Mailing Address - Fax:
Practice Address - Street 1:3107 HUNGARY SPRING RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23228
Practice Address - Country:US
Practice Address - Phone:804-501-0501
Practice Address - Fax:804-501-0509
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-06
Last Update Date:2018-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014135811223G0001X, 1223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No1223G0001XDental ProvidersDentistGeneral Practice