Individual provider Active NPI

Devin L. Stewart, D.D.S.

  • Prosthodontics
  • San Luis Obispo, CA
National Provider Identifier
1275955569
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
53930 Issued in CA
Practice address
881 Pacific St
San Luis Obispo, CA 93401-3615
Phone
(805) 543-2887
Fax
(805) 543-0129
NPI assigned
Jan 6, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X 53930 CA Primary

Addresses

Primary practice location

881 Pacific St
San Luis Obispo, CA 93401-3615

Mailing address

881 Pacific St
San Luis Obispo, CA 93401-3615
Phone (805) 543-2887

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
I20160225002690 CA Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 9133424344

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Sheets, Paquette & Wu Dental Practice Past Accepting new patients

Organizations & group practices 1

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": "1388966400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1275955569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "881 PACIFIC ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013615",
            "telephone_number": "805-543-2887",
            "fax_number": "805-543-0129"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "881 PACIFIC ST",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934013615",
            "telephone_number": "805-543-2887",
            "fax_number": "805-543-0129"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "DEVIN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-01-06",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "53930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Luis Obispo, CA

Sources for this page

Verify at the official NPI Registry.