1346415155 NPI number — DEBORAH JUNE SCHUMACHER RDH BS ME PD

Table of content: DEBORAH JUNE SCHUMACHER RDH BS ME PD (NPI 1346415155)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346415155 NPI number — DEBORAH JUNE SCHUMACHER RDH BS ME PD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHUMACHER
Provider First Name:
DEBORAH
Provider Middle Name:
JUNE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RDH BS ME PD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1346415155
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
620 W CLAIREMONT AVE
Provider Second Line Business Mailing Address:
CHIPPEWA VALLEY TECHNICAL COLLEGE DENTAL HYG CLINIC
Provider Business Mailing Address City Name:
EAU CLAIRE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
54701
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
715-833-6370
Provider Business Mailing Address Fax Number:
715-833-6447

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
620 W CLAIREMONT AVE
Provider Second Line Business Practice Location Address:
CVTC DENTAL HYGIENE PROGRAM CLINIC
Provider Business Practice Location Address City Name:
EAU CLAIRE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
54701
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
715-833-6370
Provider Business Practice Location Address Fax Number:
715-833-6447
Provider Enumeration Date:
04/23/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 124Q00000X , with the licence number:  2936016 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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