Keith David Stillwell, DDS, MAGD

Primary specialty

DentistTaxonomy code 122300000X

License

3210 Issued in AR

Practice address

4301 W Markham St
Slot 624
Little Rock, AR 72205-7101

Phone

(501) 686-8086

Fax

(501) 686-6855

NPI assigned

Apr 21, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr. K. David Stillwell Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1145577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1306802285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4301 W. MARKHAM STREET",
            "address_2": "SLOT 624",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057199",
            "telephone_number": "501-686-8086",
            "fax_number": "501-686-6855"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4301 W MARKHAM ST",
            "address_2": "SLOT 624",
            "city": "LITTLE ROCK",
            "state": "AR",
            "postal_code": "722057101",
            "telephone_number": "501-686-8086",
            "fax_number": "501-686-6855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLWELL",
        "first_name": "KEITH",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS, MAGD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-21",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AR",
            "license": "3210",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "3210",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "K.",
            "last_name": "STILLWELL",
            "middle_name": "DAVID",
            "prefix": "DR.",
            "credential": "DDS, MAGD",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Troy E Stiefvater, CRNA
• Lauren Stiles
• Lindsay M. Still, M.D.
• Mattie Still
• Abbey Marie Stillwell
• Kimo C Stine, MD
• Thomas Christian Stinnett, M.D.
• Azriel J Stinson
• Pamela Stivers, MHPP
• Julian Parker Stobaugh

• Dentist in Little Rock, AR
• Providers in Little Rock, AR by specialty
• Dentist in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.