Provider Demographics
NPI:1609480722
Name:SCHNEIDER, ALEXANDER ROBERT (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:ROBERT
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4517 LIVEOAK DR
Mailing Address - Street 2:
Mailing Address - City:CLAREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:91711-2104
Mailing Address - Country:US
Mailing Address - Phone:951-833-4397
Mailing Address - Fax:
Practice Address - Street 1:4517 LIVEOAK DR
Practice Address - Street 2:
Practice Address - City:CLAREMONT
Practice Address - State:CA
Practice Address - Zip Code:91711-2104
Practice Address - Country:US
Practice Address - Phone:951-833-4397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS1052661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADDS105266OtherDENTAL LICENSE