Provider Demographics
NPI:1871684134
Name:SCHAUMBERG, JENNIFER SARA
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:SARA
Last Name:SCHAUMBERG
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 E COMMERCIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:OAKLAND PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33334-3391
Mailing Address - Country:US
Mailing Address - Phone:954-772-9995
Mailing Address - Fax:954-772-0614
Practice Address - Street 1:701 E COMMERCIAL BLVD
Practice Address - Street 2:
Practice Address - City:OAKLAND PARK
Practice Address - State:FL
Practice Address - Zip Code:33334-3391
Practice Address - Country:US
Practice Address - Phone:954-772-9995
Practice Address - Fax:954-772-0614
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2013-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN152391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice