Provider Demographics
NPI:1922044676
Name:SCHNEIDER, WILLIAM X (DMD, MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:X
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 NEW YORK AVE
Mailing Address - Street 2:SUITE100
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-4499
Mailing Address - Country:US
Mailing Address - Phone:631-427-7373
Mailing Address - Fax:631-673-6299
Practice Address - Street 1:790 NEW YORK AVE
Practice Address - Street 2:SUITE100
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-4499
Practice Address - Country:US
Practice Address - Phone:631-427-7373
Practice Address - Fax:631-673-6299
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2011-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0453281223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD32292Medicare ID - Type Unspecified