Individual provider Active NPI

Michael Joel Stewart, D.M.D.

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Fort Gordon, GA
National Provider Identifier
1407808397
Registry record updated Mar 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
5349 Issued in AL
Practice address
USA Dental Health Activity
BLDG 38801, Academic Drive
Fort Gordon, GA 30905
Phone
(706) 787-5738
NPI assigned
May 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5349 AL
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 5349 AL Primary

Addresses

Primary practice location

USA Dental Health Activity
BLDG 38801, Academic Drive
Fort Gordon, GA 30905

Mailing address

Ft. Gordon Dental Health Activity
BLDG 38801, Academic Drive
Fort Gordon, GA 30905
Phone (706) 787-5738

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Michael J Stewart DMD LLC Current 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": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1407808397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "FT. GORDON DENTAL HEALTH ACTIVITY",
            "address_2": "BLDG 38801, ACADEMIC DRIVE",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "30905",
            "telephone_number": "706-787-5738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "USA DENTAL HEALTH ACTIVITY",
            "address_2": "BLDG 38801, ACADEMIC DRIVE",
            "city": "FORT GORDON",
            "state": "GA",
            "postal_code": "30905",
            "telephone_number": "706-787-5738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "MICHAEL",
        "middle_name": "JOEL",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-17",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "5349",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "AL",
            "license": "5349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Gordon, GA

Sources for this page

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