Individual provider · Type 1 NPI

Jack Lee Schrader, DDS

General Practice Dentistry · Sierra Vista, AZ

NPI number 1457313579 Active

Practice location

1900 Paseo San Luis
Sierra Vista, AZ 85635-4614

Call (520) 458-2415 Map

Fax (520) 458-0414

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001XAZ2165 (AZ)

General Practice Dentistry: 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.

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About NPI 1457313579

Jack Lee Schrader, DDS's National Provider Identifier is 1457313579, issued on Apr 4, 2006. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Sierra Vista, AZ. The record was last updated on Jul 13, 2026.