Provider Demographics
NPI:1043832975
Name:SCHMENK, ROBERT CONNOR (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CONNOR
Last Name:SCHMENK
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 1:273 COATES CT
Mailing Address - Street 2:
Mailing Address - City:NORTH LEWISBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43060-9010
Mailing Address - Country:US
Mailing Address - Phone:419-615-7347
Mailing Address - Fax:
Practice Address - Street 1:3613 RESERVE COMMONS DR
Practice Address - Street 2:
Practice Address - City:MEDINA
Practice Address - State:OH
Practice Address - Zip Code:44256-8179
Practice Address - Country:US
Practice Address - Phone:419-615-7347
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-14
Last Update Date:2023-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.026124122300000X, 1223D0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223D0004XDental ProvidersDentistDental Anesthesiology
No122300000XDental ProvidersDentist