Individual provider Active NPI

Charles F Stewart, DDS

  • General Practice Dentistry
  • Santa Paula, CA
National Provider Identifier
1184759391
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
24871 Issued in CA
Practice address
132 N 10TH St
Santa Paula, CA 93060-2803
Phone
(805) 525-7649
Fax
(805) 525-8659
NPI assigned
Feb 21, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 24871 CA Primary

Addresses

Primary practice location

132 N 10TH St
Santa Paula, CA 93060-2803

Mailing address

132 N 10TH St
Santa Paula, CA 93060-2803
Phone (805) 525-7649

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20160222001170 CA Order and Referring Only - DentistPractitioner - Dentist 6406151901

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24871CAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1184759391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 N 10TH ST",
            "city": "SANTA PAULA",
            "state": "CA",
            "postal_code": "930602803",
            "telephone_number": "805-525-7649",
            "fax_number": "805-525-8659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "132 N 10TH ST",
            "city": "SANTA PAULA",
            "state": "CA",
            "postal_code": "930602803",
            "telephone_number": "805-525-7649",
            "fax_number": "805-525-8659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "CHARLES",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "24871",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Paula, CA

Sources for this page

Verify at the official NPI Registry.