Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

DR. JACK LEE SCHRADER DDS
NPI 1457313579
Dentist - General Practice in Sierra Vista, AZ

Active since April 04, 2006
1900 PASEO SAN LUIS, SIERRA VISTA, AZ 85635(520) 458-2415(520) 458-0414 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Dr. Jack Lee Schrader Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACK LEE SCHRADER DDS (NPI 1457313579) is an individual general practice provider in Sierra Vista, Arizona, licensed in Arizona (AZ2165) and active in the NPI registry since April 2006.

NPPES Registry Identity

NPI1457313579
Entity TypeIndividualMale
Primary Taxonomy1223G0001X
Provider Legal NameDR. JACK LEE SCHRADERCredential: DDS
Location Address1900 PASEO SAN LUISSierra Vista, AZ 85635-4614
Mailing Address1900 Paseo San LuisSierra Vista, AZ 85635-4614 · (520) 458-2415 · Fax (520) 458-0414
Fax(520) 458-0414
Sole ProprietorNo
Enumeration DateApril 4, 2006
Last NPPES UpdateJuly 13, 2026
NPI 1457313579 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License Licensed in AZ · AZ2165
Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

1900 PASEO SAN LUIS, Sierra Vista, AZ 85635

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Dentist (General Practice)
1900 PASEO SAN LUIS
SIERRA VISTA, AZ 85635
Dentist (General Practice)
1900 PASEO SAN LUIS
SIERRA VISTA, AZ 85635
Clinic/Center (Dental)
1900 PASEO SAN LUIS
SIERRA VISTA, AZ 85635
Dentist (General Practice)
1900 PASEO SAN LUIS
SIERRA VISTA, AZ 85635
Dentist (General Practice)
1900 PASEO SAN LUIS
SIERRA VISTA, AZ 85635

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Schrader's NPI number?

The NPI number for Jack Schrader is 1457313579. It was assigned to this individual provider in the NPPES registry on April 4, 2006.

Where is Jack Schrader located?

Jack Schrader practices at 1900 Paseo San Luis, Sierra Vista, AZ 85635. The listed phone number is (520) 458-2415.

What is Jack Schrader's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

When was this NPI record last updated?

The NPPES record for Jack Schrader was last updated on July 13, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.