Provider Demographics
NPI:1598843906
Name:SCHELM, WILLIAM ORVILLE (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:ORVILLE
Last Name:SCHELM
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 1:5933 STELLHORN RD
Mailing Address - Street 2:
Mailing Address - City:FT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46815-5257
Mailing Address - Country:US
Mailing Address - Phone:260-485-3432
Mailing Address - Fax:260-485-3432
Practice Address - Street 1:5933 STELLHORN RD
Practice Address - Street 2:
Practice Address - City:FT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46815-5257
Practice Address - Country:US
Practice Address - Phone:260-485-3432
Practice Address - Fax:260-485-3432
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2015-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12006528A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100050110AMedicaid