Provider Demographics
NPI:1578679353
Name:SCHULTE, STEPHEN G (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:G
Last Name:SCHULTE
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 1:15301 W 87TH STREET PKWY
Mailing Address - Street 2:STE 210
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1401
Mailing Address - Country:US
Mailing Address - Phone:913-492-0588
Mailing Address - Fax:913-492-0588
Practice Address - Street 1:15301 W 87TH STREET PKWY
Practice Address - Street 2:STE 210
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1401
Practice Address - Country:US
Practice Address - Phone:913-492-0588
Practice Address - Fax:913-492-0588
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2007-07-08
Deactivation Date:2006-12-18
Deactivation Code:
Reactivation Date:2007-04-10
Provider Licenses
StateLicense IDTaxonomies
KS57361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS08883038OtherBCBS