DR. EVAN RANDALL SCHMIDT (NPI# 1275190183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275190183 |
| Entity Type | Individual |
| Full Name | DR. EVAN RANDALL SCHMIDT |
| Credential | DDS,MSD |
| Practice Address |
3110 Willowcreek Rd Portage IN 46368-4424 |
| Practice Telephone | 2194770089 |
| Mailing Telephone | 2194770089 |
| Enumeration Date | 2019-05-27 |
| Last Update Date | 2019-05-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223X0400X |
Dentist Specialization: Orthodontics and Dentofacial Orthopedics |
12012798A | IN | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | DRIVERS LICENSE NUMBER | 1420-51-3376 | 01 |
| IN | ORTHODONTICS | 1223X0400X | 01 |
| IN | INDIANA DENTAL LICENSE | 12012798A | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811398282 | Evan Schmidt | Specialist/Technologist | 1855 S Koeller St, Oshkosh, WI 54902-6186 | 2014-09-04 |
| Street Address |
3110 WILLOWCREEK RD |
| City | PORTAGE |
| State | IN |
| Zip Code | 46368-4424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366041121 | Latresa Renee Sims | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1777 Armstrong St. Suite C., Portage, IN 46368 | 2020-10-22 |
| 1831576693 | Bishara Robert Khoury | Family Medicine | 3545 Arbor Blvd Ste E, Portage, IN 46368 | 2015-04-30 |
| 1962813535 | Diane Farrington | Pharmacist | 6050 Us Hwy 6, Portage, IN 46368 | 2014-05-16 |
| 1588827562 | Jennifer Ann Rumpel | Allergy & Immunology | 6375 Us Highway 6 Ste C, Portage, IN 46368 | 2008-07-09 |
| 1588822688 | Total Renal Care Inc | Clinic/Center | 5823 Us Highway 6, Portage, IN 46368 | 2008-05-27 |
| 1235321480 | Michael Wendahl | Physical Therapist | 3691 Willowcreek Road, Suite 100, Portage, IN 46368 | 2007-08-13 |
| 1679663603 | Stephen V Headley | Family Medicine | 3283 Willowcreek Rd, Portage, IN 46368 | 2006-10-13 |
| 1730276486 | Robert Tan Ang | Psychiatry & Neurology | 3156 Willowcreek Road, Portage, IN 46368 | 2006-10-06 |
| 1013029883 | Primary Care PC | Family Medicine | 3125 Willowcreek Road, Portage, IN 46368 | 2006-08-31 |
| 1104936962 | Margaret Eileen Griffith | Dentist | 2646 Lois Street, Portage, IN 46368 | 2006-08-30 |
| Find all providers in zip 46368 | ||||
| Taxonomy Code | 1223X0400X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Orthodontics and Dentofacial Orthopedics |
| That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of functional forces within the craniofacial complex. Major responsibilities of orthodontic practice include the diagnosis, prevention, interception and treatment of all forms of malocclusion of the teeth and associated alterations in their surrounding structures; the design, application and control of functional and corrective appliances; and the guidance of the dentition and its supporting structures to attain and maintain optimum occlusal relations in physiologic and esthetic harmony among facial and cranial structures. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508160599 | Jamie Gail Sage | Dentist | 3275 Cooley Ct, Suite 155, Portage, MI 49024-7433 | 2011-01-05 |
| 1487867610 | Steven Jay Bowman | Dentist | 1314 W Milham Ave, Portage, MI 49024-1209 | 2007-05-07 |
| 1902940653 | Kenneth William Grabowski | Dentist | 7864 Moors Bridge Rd, Portage, MI 49024-4424 | 2007-02-16 |
| 1780778597 | Brenda Kay Stenftenagel | Dentist | 3204 Lancer St, Suite A, Portage, IN 46368-4490 | 2006-10-03 |
| 1669897807 | Kwong Orthodontics, PC | Dentist | 6121 S Westnedge Ave, Portage, MI 49002-2882 | 2014-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659970036 | Sarah Buedel | Dentist | 900 Tutor Ln Ste 103, Evansville, IN 47715-7295 | 2020-10-18 |
| 1720695828 | Candid Indiana, P.C. | Dentist | 5 Washington St Fl 3, Valparaiso, IN 46383-4768 | 2020-09-23 |
| 1992357453 | Brace Yourself Orthodontics LLC | Dentist | 16329 State Road 23, South Bend, IN 46635-1457 | 2019-07-15 |
| 1417515255 | Mark Rex Rosenthall | Dentist | 3901 N Wheeling Ave, Muncie, IN 47304-1769 | 2019-06-05 |
| 1508325879 | Rlm Orthodontics LLC | Dentist | 298 S 10th St Ste 100, Noblesville, IN 46060-2741 | 2019-03-17 |
| 1699234955 | Stonegate Orthodontics LLC | Dentist | 6857 W Stonegate Dr Ste B, Zionsville, IN 46077-8023 | 2019-03-17 |
| 1467917278 | Michael J Hacken | Dentist | 51565 Bittersweet Rd, Granger, IN 46530-8859 | 2019-02-06 |
| 1992290746 | Bbb of In, LLC | Dentist | 905 S College Mall Rd, Bloomington, IN 47401-6302 | 2018-06-25 |
| 1518456557 | Smile Doctors of Indiana, P.C. | Dentist | 1410 S Quail Run Rd, Vincennes, IN 47591-6845 | 2018-05-04 |
| 1508376708 | Glander Rochford Orthodontics, LLC | Dentist | 8445 S Emerson Ave Ste 102, Indianapolis, IN 46237-9597 | 2017-10-03 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.