Individual provider Active NPI

Charles Hillam Stuart, D.D.S.

  • Endodontics
  • El Paso, TX
National Provider Identifier
1023078284
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
22706 Issued in TX
Practice address
7211 N Mesa St Ste 2
El Paso, TX 79912-3611
Phone
(915) 581-3391
Fax
(915) 581-4825
NPI assigned
Mar 23, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X 4789791-9921 UT
Endodontics 1223E0200X 22706 TX Primary

Addresses

Primary practice location

7211 N Mesa St Ste 2
El Paso, TX 79912-3611

Mailing address

6249 Brisa del Mar Dr
El Paso, TX 79912-1854
Phone (915) 832-0592

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20140218000667 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8022247923

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
22706TXMDClinical Psychologist
4789791-9921UTMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1143072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023078284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6249 BRISA DEL MAR DR",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799121854",
            "telephone_number": "915-832-0592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7211 N MESA ST STE 2",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799123611",
            "telephone_number": "915-581-3391",
            "fax_number": "915-581-4825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUART",
        "first_name": "CHARLES",
        "middle_name": "HILLAM",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "UT",
            "license": "4789791-9921",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "TX",
            "license": "22706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in El Paso, TX

Sources for this page

Verify at the official NPI Registry.