Fredrick E. Stuart, D.D.S

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

224875 Issued in CA

Practice address

502 Center St
El Segundo, CA 90245-3201

Phone

(310) 322-9476

Fax

(310) 322-5224

NPI assigned

Nov 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Es Kaleka DMD Inc

  • Dentist
  • El Segundo, CA
  • NPI 1942601786
  NPD (past)

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

{
    "created_epoch": "1162771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417026469",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "502 CENTER ST",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902453201",
            "telephone_number": "310-322-9476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "502 CENTER ST",
            "city": "EL SEGUNDO",
            "state": "CA",
            "postal_code": "902453201",
            "telephone_number": "310-322-9476",
            "fax_number": "310-322-5224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUART",
        "first_name": "FREDRICK",
        "middle_name": "E.",
        "name_prefix": "Dr.",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "224875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Madison Stromberg
• Elizabeth Stromquist
• Destinee Stroupe
• Samantha Strukel
• Beverly Stuart
• Sonnara Stubbs
• Yao Su
• Joyce Suah
• Jacqueline May Sudthivongse
• Amaia Suero

• General Practice Dentistry in El Segundo, CA
• Providers in El Segundo, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.