Active NPI
George J Stuart Jr., D.D.S.
- Periodontics
- Charlotte, NC
National Provider Identifier
1710100813
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 3505
- Practice address
- 1335 Elizabeth Ave
CPCC Department of Dental Hygiene
Charlotte, NC 28204 - Phone
- (704) 330-6483
- Fax
- (704) 330-6477
- NPI assigned
- Apr 10, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 3505 | NC | Primary |
Addresses
Primary practice location
1335 Elizabeth Ave
CPCC Department of Dental Hygiene
Charlotte, NC 28204
Mailing address
4139 Oldfield Rd
Charlotte, NC 28226
Phone (704) 542-9420
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 |
|---|---|---|---|
| 3505 | NC | MD | Periodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176163200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1367193600000",
"number": "1710100813",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4139 OLDFIELD RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28226",
"telephone_number": "704-542-9420",
"fax_number": "704-374-1731"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1335 ELIZABETH AVE",
"address_2": "CPCC DEPARTMENT OF DENTAL HYGIENE",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "28204",
"telephone_number": "704-330-6483",
"fax_number": "704-330-6477"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STUART",
"first_name": "GEORGE",
"middle_name": "J",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-04-10",
"last_updated": "2013-04-29",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NC",
"license": "3505",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.