Individual provider Active NPI

Christopher M Stewart, D.D.S

  • Dentist
  • Avenel, NJ
National Provider Identifier
1013359249
Registry record updated May 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22DI02542200 Issued in NJ
Practice address
1030 Saint Georges Ave
304
Avenel, NJ 07001-1390
Phone
(732) 750-0707
Fax
(732) 750-5781
NPI assigned
Jul 30, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 25, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 22DI02542200 NJ Primary

Addresses

Primary practice location

1030 Saint Georges Ave
304
Avenel, NJ 07001-1390

Mailing address

1030 Saint Georges Ave
Avenel, NJ 07001-1390
Phone (732) 750-0707

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150220001514 NJ Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 1557686292

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern Dental of Laurel Springs, LLC Past Accepting new patients
Eastern Dental Holdings, LLC Dentist PastSince Aug 2, 2020 Accepting new patients
Eastern Dental of Vineland, LLC Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1375142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1621900800000",
    "number": "1013359249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 SAINT GEORGES AVE",
            "city": "AVENEL",
            "state": "NJ",
            "postal_code": "070011390",
            "telephone_number": "732-750-0707",
            "fax_number": "732-750-5781"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 SAINT GEORGES AVE",
            "address_2": "304",
            "city": "AVENEL",
            "state": "NJ",
            "postal_code": "070011390",
            "telephone_number": "732-750-0707",
            "fax_number": "732-750-5781"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "CHRISTOPHER",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-30",
        "last_updated": "2021-05-25",
        "certification_date": "2021-05-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NJ",
            "license": "22DI02542200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Avenel, NJ

Sources for this page

Verify at the official NPI Registry.