Individual provider Active NPI

Ian Robert Stewart, DDS

  • General Practice Dentistry
  • Gallatin, TN
National Provider Identifier
1124695515
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
11907 Issued in TN
Practice address
923 Nashville Pike Ste a
Gallatin, TN 37066-4384
Phone
(615) 241-8022
NPI assigned
Jun 5, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 12254 NC
General Practice Dentistry 1223G0001X 11907 TN Primary

Addresses

Primary practice location

923 Nashville Pike Ste a
Gallatin, TN 37066-4384

Mailing address

923 Nashville Pike Ste a
Gallatin, TN 37066-4384
Phone (615) 241-8022

Other practice location 1

115 Southern Dunes Dr
Vass, NC 28394-9218
Phone (910) 693-8030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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
I20250603000160 TN Order and Referring Only - DentistPractitioner - Dentist 4284143173

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11907TNMDGeneral Practice Dentistry
12254NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Edward F. Scammon DMD PA General Practice PastSince Jun 1, 2021 Accepting new patients
Gallatin Smiles Dentistry,PC Dentist PastSince Aug 7, 2022 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": "1622851200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1124695515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "923 NASHVILLE PIKE STE A",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370664384",
            "telephone_number": "615-241-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "923 NASHVILLE PIKE STE A",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370664384",
            "telephone_number": "615-241-8022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "115 Southern Dunes Dr",
            "address_purpose": "LOCATION",
            "city": "Vass",
            "state": "NC",
            "postal_code": "283949218",
            "country_code": "US",
            "telephone_number": "910-693-8030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STEWART",
        "first_name": "IAN",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "12254",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TN",
            "license": "11907",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallatin, TN

Sources for this page

Verify at the official NPI Registry.