Provider Demographics
NPI:1831221241
Name:SCHILL, FREDERICK J (DDS)
Entity type:Individual
Prefix:DR
First Name:FREDERICK
Middle Name:J
Last Name:SCHILL
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:FREDERICK
Other - Middle Name:J
Other - Last Name:SCHILL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:4900 REED RD
Mailing Address - Street 2:SUITE 127
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43220-3164
Mailing Address - Country:US
Mailing Address - Phone:614-459-1700
Mailing Address - Fax:
Practice Address - Street 1:4900 REED RD
Practice Address - Street 2:SUITE 127
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43220-3164
Practice Address - Country:US
Practice Address - Phone:614-459-1700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH16114122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist