Provider Demographics
NPI:1871166637
Name:SCHEINTHAL, ELIZABETH DIANA (DMD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:DIANA
Last Name:SCHEINTHAL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:777 N VAN BUREN ST APT 1613
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53202-3861
Mailing Address - Country:US
Mailing Address - Phone:512-673-3196
Mailing Address - Fax:
Practice Address - Street 1:10618 N PORT WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:MEQUON
Practice Address - State:WI
Practice Address - Zip Code:53092-5013
Practice Address - Country:US
Practice Address - Phone:262-241-0400
Practice Address - Fax:262-643-4272
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-20
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI6001164-151223P0221X
PADS0434501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty