Provider Demographics
NPI:1205975455
Name:JAMES P. SCHAEFFER D.D.S. DENTAL CORPORATION
Entity type:Organization
Organization Name:JAMES P. SCHAEFFER D.D.S. DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:P
Authorized Official - Last Name:SCHAEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-604-0449
Mailing Address - Street 1:2150 N ROSE AVE
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93036-5058
Mailing Address - Country:US
Mailing Address - Phone:805-604-0449
Mailing Address - Fax:805-604-4497
Practice Address - Street 1:2150 N ROSE AVE
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93036-5058
Practice Address - Country:US
Practice Address - Phone:805-604-0449
Practice Address - Fax:805-604-4497
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA43855122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty