Provider Demographics
NPI:1801200035
Name:SCHOENLY, NATHAN (DDS)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:
Last Name:SCHOENLY
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 1:139 SPRINGVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-3117
Mailing Address - Country:US
Mailing Address - Phone:781-789-4010
Mailing Address - Fax:
Practice Address - Street 1:7115 LEESBURG PIKE
Practice Address - Street 2:SUITE 309
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22043-2367
Practice Address - Country:US
Practice Address - Phone:703-534-0330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-16
Last Update Date:2014-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04014143361223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics