Provider Demographics
NPI:1972127363
Name:SCHUMACHER, JORDAN N (DDS)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:N
Last Name:SCHUMACHER
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 1:7635 W BLUEMOUND RD STE 208
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53213-3500
Mailing Address - Country:US
Mailing Address - Phone:414-258-6330
Mailing Address - Fax:
Practice Address - Street 1:7635 W BLUEMOUND RD STE 208
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53213-3500
Practice Address - Country:US
Practice Address - Phone:414-258-6330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-02
Last Update Date:2020-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1002360122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist