Schmidt, Evan Randall

Schmidt, Evan Randall is an individual health care provider with primary practice located at 3110 Willowcreek Rd , Portage IN 46368-4424. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Schmidt, Evan Randall can be contacted via phone (219) 477-0089.

Contact Information

Primary practice address
3110 Willowcreek Rd Portage IN 46368-4424
Phone: (219) 477-0089
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X 12012798A Indiana

Profile Details

NPI number 1275190183
LBN Legal business name Schmidt, Evan Randall
Credentials DDS,MSD
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2019
Last updated May 27th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275190183 NPPES
Indiana Other 1223X0400X ORTHODONTICS
Indiana Other 12012798A ORTHODONTICS
Indiana Other 1420-51-3376 ORTHODONTICS

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