Provider Demographics
NPI:1255429114
Name:SCHIMP, JEFFREY LOUIS (DDS)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:LOUIS
Last Name:SCHIMP
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 1:1141 S ROSE
Mailing Address - Street 2:
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49001-2652
Mailing Address - Country:US
Mailing Address - Phone:269-344-0406
Mailing Address - Fax:269-344-4346
Practice Address - Street 1:1141 S ROSE
Practice Address - Street 2:SUITE D
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49001-2652
Practice Address - Country:US
Practice Address - Phone:269-344-0406
Practice Address - Fax:269-344-4346
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI13375122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist