Jr Stewart D.D.S. Enterprises LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

8658 Issued in IN

Legal business name

JR STEWART D.D.S. ENTERPRISES LLC

Practice address

108 South Illinois Street
Wanatah, IN 46390-0359

Phone

(219) 733-2929

Fax

(219) 733-1329

NPI assigned

Oct 5, 2013

Last updated

Oct 5, 2013By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Joseph R Stewart, D.D.S.NPI 1578681474

Title

Dr.

Phone

(219) 733-2929

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joseph R. Stewart, D.D.S.

  • General Practice Dentistry
  • Wanatah, IN
  • NPI 1578681474
  NPD (past) Authorized official

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

{
    "created_epoch": "1380931200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380931200000",
    "number": "1982031928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 359",
            "address_2": "108 SOUTH ILLINOIS STREET",
            "city": "WANATAH",
            "state": "IN",
            "postal_code": "463900359",
            "telephone_number": "219-733-2929",
            "fax_number": "219-733-1329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 SOUTH ILLINOIS STREET",
            "city": "WANATAH",
            "state": "IN",
            "postal_code": "463900359",
            "telephone_number": "219-733-2929",
            "fax_number": "219-733-1329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JR STEWART D.D.S. ENTERPRISES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-05",
        "last_updated": "2013-10-05",
        "status": "A",
        "authorized_official_last_name": "STEWART",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DR.",
        "authorized_official_telephone_number": "219-733-2929",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "IN",
            "license": "8658",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Durable Medical Equipment & Medical Supplies in Wanatah, IN
• Providers in Wanatah, IN by specialty
• Durable Medical Equipment & Medical Supplies in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 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.