Individual provider Active NPI

Stewart Helton, D.M.D

  • General Practice Dentistry
  • Loganville, GA
National Provider Identifier
1023497385
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN014992 Issued in GA
Practice address
3238 Krisam Creek Dr
Loganville, GA 30052-7942
Phone
(770) 466-0474
NPI assigned
May 20, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X APPLIED FOR GA
General Practice Dentistry 1223G0001X DN014992 GA Primary

Addresses

Primary practice location

3238 Krisam Creek Dr
Loganville, GA 30052-7942

Mailing address

3238 Krisam Creek Dr
Loganville, GA 30052-7942

Other practice location 1

4054 Buford Hwy NE
Atlanta, GA 30345-1678
Phone (404) 477-5665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20151221000510 GA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 8628379476

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
APPLIED FORGAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Candler Road Dental, PC General Practice Past Accepting new patients
Creekside Dentistry, LLC General Practice Past Accepting new patients

Organizations & group practices 2

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": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1023497385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3238 KRISAM CREEK DR",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300527942"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3238 KRISAM CREEK DR",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300527942",
            "telephone_number": "770-466-0474"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4054 Buford Hwy NE",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303451678",
            "country_code": "US",
            "telephone_number": "404-477-5665",
            "fax_number": "404-477-5666",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HELTON",
        "first_name": "STEWART",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-20",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "APPLIED FOR",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN014992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loganville, GA

Sources for this page

Verify at the official NPI Registry.