Provider Demographics
NPI:1265597140
Name:SCHROTT, JONATHAN (DDS)
Entity type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:
Last Name:SCHROTT
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 1:401 W END AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5724
Mailing Address - Country:US
Mailing Address - Phone:212-877-6742
Mailing Address - Fax:646-259-0044
Practice Address - Street 1:401 W END AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-5724
Practice Address - Country:US
Practice Address - Phone:212-877-6742
Practice Address - Fax:646-259-0044
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0371411223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice