Active NPI
Keith J Stewart, D.D.S.
- Orthodontics and Dentofacial Orthopedics Dentistry
- Cleburne, TX
National Provider Identifier
1568485068
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthodontics and Dentofacial Orthopedics Dentistry
- License
- 12243
- Practice address
- 110 Del Rio CT
Cleburne, TX 76033-5125 - Phone
- (817) 641-3331
- Fax
- (817) 641-6191
- NPI assigned
- Jul 25, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthodontics and Dentofacial Orthopedics Dentistry | 1223X0400X | 12243 | TX | Primary |
Addresses
Primary practice location
110 Del Rio CT
Cleburne, TX 76033-5125
Mailing address
110 Del Rio CT
Cleburne, TX 76033-5125
Phone (817) 641-3331
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 81537 | Other | TX | UNITED CONCORDIA |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12243 | TX | MD | Orthodontics and Dentofacial Orthopedic Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153785600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1568485068",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 DEL RIO CT",
"city": "CLEBURNE",
"state": "TX",
"postal_code": "760335125",
"telephone_number": "817-641-3331",
"fax_number": "817-641-6191"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 DEL RIO CT",
"city": "CLEBURNE",
"state": "TX",
"postal_code": "760335125",
"telephone_number": "817-641-3331",
"fax_number": "817-641-6191"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "KEITH",
"middle_name": "J",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-25",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223X0400X",
"taxonomy_group": "",
"desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
"state": "TX",
"license": "12243",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED CONCORDIA",
"identifier": "81537",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cleburne, TX
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.