Provider Demographics
NPI:1578647848
Name:SCHRAD, DAVID JON (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JON
Last Name:SCHRAD
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 1:1415 HARNEY ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68102-2250
Mailing Address - Country:US
Mailing Address - Phone:402-341-7576
Mailing Address - Fax:402-341-8975
Practice Address - Street 1:1415 HARNEY ST STE 100
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68102-2250
Practice Address - Country:US
Practice Address - Phone:023-417-5764
Practice Address - Fax:402-341-8975
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-24
Last Update Date:2024-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE60831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice