Individual provider Active NPI

Roderick David Stewart, DDS

  • General Practice Dentistry
  • North Tonawanda, NY
National Provider Identifier
1871933937
Registry record updated Jul 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
056635-1 Issued in NY
Practice address
3349 Niagara Falls Blvd
North Tonawanda, NY 14120-1213
Phone
(716) 694-1777
Fax
(716) 694-1888
NPI assigned
Jul 3, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 056635-1 NY Primary

Addresses

Primary practice location

3349 Niagara Falls Blvd
North Tonawanda, NY 14120-1213

Mailing address

3349 Niagara Falls Blvd
North Tonawanda, NY 14120-1213
Phone (716) 694-1777

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

LicenseStateTypeSpecialty
056635-1NYMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Kathleen M Casacci DDS PC PastSince Jul 1, 2020 Accepting new patients
Wheatfield Dental Group General Practice PastSince Oct 31, 2021 Accepting new patients

Organizations & group practices 2

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": "1372809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372809600000",
    "number": "1871933937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3349 NIAGARA FALLS BLVD",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141201213",
            "telephone_number": "716-694-1777",
            "fax_number": "716-694-1888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3349 NIAGARA FALLS BLVD",
            "city": "NORTH TONAWANDA",
            "state": "NY",
            "postal_code": "141201213",
            "telephone_number": "716-694-1777",
            "fax_number": "716-694-1888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "RODERICK",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-03",
        "last_updated": "2013-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "056635-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Tonawanda, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 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.

Verify at the official NPI Registry.