Rod C Stewart, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

13036 Issued in TX

Practice address

310 W Montgomery St
Willis, TX 77378-8825

Phone

(936) 856-2500

Fax

(936) 856-2548

NPI assigned

Feb 16, 2007

Last updated

Jul 8, 2007By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1881738854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "310 W MONTGOMERY ST",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773788825",
            "telephone_number": "936-856-2500",
            "fax_number": "936-856-2548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "310 W MONTGOMERY ST",
            "city": "WILLIS",
            "state": "TX",
            "postal_code": "773788825",
            "telephone_number": "936-856-2500",
            "fax_number": "936-856-2548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEWART",
        "first_name": "ROD",
        "middle_name": "C",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "13036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL TAX ID",
            "identifier": "741666701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Southern Medical Supplies
• Jacqueline Denise Sparks
• Karen Sue Spartz
• Brandi Stephenson, M.S., CCC-SLP
• Katie Stewart, LCDC
• Gwendolyn Loretta Stone, LVN
• Levi Ross Stone, MSN, APRN, FNP-C
• Nancy Storie, RN
• Tanita Shanta Sullivan
• Stacey Jo Swatzel, BCBA, LBA

• General Practice Dentistry in Willis, TX
• Providers in Willis, TX by specialty
• General Practice Dentistry in Texas

• 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.

Verify at the official NPI Registry.