Provider Demographics
NPI:1871692830
Name:SCHMIDT, ANDREW D (DDS)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:D
Last Name:SCHMIDT
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 1:3115 HOWE PL STE 201
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-5647
Mailing Address - Country:US
Mailing Address - Phone:360-738-4772
Mailing Address - Fax:360-922-0299
Practice Address - Street 1:3115 HOWE PL STE 201
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-5647
Practice Address - Country:US
Practice Address - Phone:360-738-4772
Practice Address - Fax:360-922-0299
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI57950151223X0400X
WA108541223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI5795015OtherSTATE DENTAL LICENSE
WA10854OtherWASHINGTON DENTAL LICENSE