Individual provider Active NPI

Stephen Frederick Dewey, DDS

  • Dentist
  • Charlevoix, MI
National Provider Identifier
1548314289
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
2901019346 Issued in MI
Practice address
220 W Garfield Ave
Charlevoix, MI 49720-1631
Phone
(231) 547-6523
Fax
(231) 547-6238
NPI assigned
Jan 22, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 2901019346 MI Primary

Addresses

Primary practice location

220 W Garfield Ave
Charlevoix, MI 49720-1631

Mailing address

196 Crescent Ave
Traverse City, MI 49684-9346
Phone (231) 943-8945

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20161209001915 MI Order and Referring Only - DentistPractitioner - Dentist 7517247463

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901019346MIMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen F Dewey, DDS 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548314289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "196 CRESCENT AVE",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849346",
            "telephone_number": "231-943-8945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 W GARFIELD AVE",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201631",
            "telephone_number": "231-547-6523",
            "fax_number": "231-547-6238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEWEY",
        "first_name": "STEPHEN",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MI",
            "license": "2901019346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlevoix, MI

Sources for this page

Verify at the official NPI Registry.