MEDICARE: DR. TANGELES STEWART

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	126800000X	Dental Assistant		LA

General Provider Information

NPI Number	:	1801600887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TANGELES STEWART

Provider Business Mailing Address
First Line	:	6765 PERIMETER DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70812-1035
Country	:	US
Telephone Number	:	225-921-1138
Fax Number	:

Provider Business Practice Location Address
First Line	:	6765 PERIMETER DR
Second Line	:
City	:	BATON ROUGE
State	:	LA
Zip	:	70812-1035
Country	:	US
Telephone Number	:	225-921-1138
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/03/2025
Last Update Date	:	02/03/2025

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Directions to “ DR. TANGELES STEWART ” Practice Location

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