Stewart M Gegenheimer, DDS
Individual provider Active NPI Dentist · Robert, LA
NPI 1174848048 · NPPES record last updated Apr 2, 2010
Key facts
- NPI
- 1174848048
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 4352 (LA)
- Practice address
- 23138 Wittie LN
Robert, LA 70455-1824 - Phone
- (504) 616-6213
- NPI assigned
- Apr 2, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4352 | LA | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4352 | LA | Yes |
Addresses
Primary practice location
23138 Wittie LN
Robert, LA 70455-1824
Mailing address
23138 Wittie LN
Robert, LA 70455-1824
Phone (504) 616-6213
Other names
- Dr. Stewart M Gegenheimer
Other providers in Robert, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 2, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.