Provider Demographics
NPI:1790836476
Name:SCHIFFEL, ROBERT JAMES (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JAMES
Last Name:SCHIFFEL
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 1:4316 HENSON DR
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28405-7424
Mailing Address - Country:US
Mailing Address - Phone:910-395-1585
Mailing Address - Fax:910-392-5249
Practice Address - Street 1:4316 HENSON DR
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28405-7424
Practice Address - Country:US
Practice Address - Phone:910-395-1585
Practice Address - Fax:910-392-5249
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC55271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8997604Medicaid
NC182423OtherUNITED CONCORDIA
NC97604OtherBCBS
NC8997604Medicaid