Bradley M Stewart DMD LLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

3105-99 Issued in MS

Legal business name

BRADLEY M STEWART DMD LLC

Practice address

6855 Crumpler Blvd Ste 100
Olive Branch, MS 38654-1930

Phone

(901) 262-0217

NPI assigned

Nov 28, 2017

Last updated

Nov 28, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Bradley Mitchell Stewart, DMD

Title

Owner

Phone

(901) 262-0217

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1511827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1511827200000",
    "number": "1366956419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6855 CRUMPLER BLVD STE 100",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386541930",
            "telephone_number": "901-262-0217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6855 CRUMPLER BLVD STE 100",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386541930",
            "telephone_number": "901-262-0217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY M STEWART DMD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-28",
        "last_updated": "2017-11-28",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_middle_name": "MITCHELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-262-0217",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "MS",
            "license": "3105-99",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shandra Bouzemann
• Sondra Bowen
• Traci D Bowen
• Taylor Breanne Bowers, CF-SLP
• Jordan Boyd
• Susan C Brame, FNP
• Yolanda Brannon, DC
• Jazmine Briggs
• Fredricca Jazzman Brock, BCBA
• Brown Family Retina

• Dental Clinic/Center in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Dental Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; 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.