Active NPI
Stewart Kimball, DDS
- General Practice Dentistry
- Chandler, AZ
National Provider Identifier
1275949893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- D008992
- Practice address
- 1257 W Warner Rd
Suite B2
Chandler, AZ 85224-2713 - Phone
- (480) 820-3755
- NPI assigned
- Jul 2, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D008992 | AZ | Primary |
Addresses
Primary practice location
1257 W Warner Rd
Suite B2
Chandler, AZ 85224-2713
Mailing address
6505 S San Jacinto St
Gilbert, AZ 85298-4318
Phone (801) 360-6211
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161031002178 | AZ | Order and Referring Only - Dentist | 8729366489 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D008992 | AZ | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1404259200000",
"number": "1275949893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6505 S SAN JACINTO ST",
"city": "GILBERT",
"state": "AZ",
"postal_code": "852984318",
"telephone_number": "801-360-6211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1257 W WARNER RD",
"address_2": "SUITE B2",
"city": "CHANDLER",
"state": "AZ",
"postal_code": "852242713",
"telephone_number": "480-820-3755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KIMBALL",
"first_name": "STEWART",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-07-02",
"last_updated": "2014-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "AZ",
"license": "D008992",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chandler, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.