Provider Demographics
NPI:1972639243
Name:SCHAMBACH, WILLIAM LEE (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LEE
Last Name:SCHAMBACH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2232 BERMUDA DUNES PL
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-2781
Mailing Address - Country:US
Mailing Address - Phone:805-488-0544
Mailing Address - Fax:805-456-2164
Practice Address - Street 1:300 E ESPLANADE DR STE 1600
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-1283
Practice Address - Country:US
Practice Address - Phone:805-488-0544
Practice Address - Fax:805-456-2164
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2018-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA480101223S0112X, 1223P0700X
KY43571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral Practice