Provider Demographics
NPI:1669692133
Name:SCHNAIDT, DAWN (RDH)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:
Last Name:SCHNAIDT
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 W EL PORTAL
Mailing Address - Street 2:
Mailing Address - City:SAN CLEMENTE
Mailing Address - State:CA
Mailing Address - Zip Code:92672-4632
Mailing Address - Country:US
Mailing Address - Phone:949-492-1984
Mailing Address - Fax:949-492-1874
Practice Address - Street 1:128 W EL PORTAL
Practice Address - Street 2:
Practice Address - City:SAN CLEMENTE
Practice Address - State:CA
Practice Address - Zip Code:92672-4632
Practice Address - Country:US
Practice Address - Phone:949-492-1984
Practice Address - Fax:949-492-1874
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21384124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist