Provider Demographics
NPI:1871531905
Name:STEWART, STEVEN JOHN (DDS)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JOHN
Last Name:STEWART
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8439 DAVENTRY CT
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-9185
Mailing Address - Country:US
Mailing Address - Phone:614-530-9266
Mailing Address - Fax:
Practice Address - Street 1:43 E NORTH ST
Practice Address - Street 2:
Practice Address - City:WORTHINGTON
Practice Address - State:OH
Practice Address - Zip Code:43085-4027
Practice Address - Country:US
Practice Address - Phone:614-885-6212
Practice Address - Fax:614-885-0395
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH21447122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist