Healthcare Provider Details

I. General information

NPI: 1164231742
Provider Name (Legal Business Name): STEWART ORTHODONTICS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2025
Last Update Date: 01/07/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1731 HILL PARK DRIVE
JONESBORO AR
72401
US

IV. Provider business mailing address

1731 HILL PARK DRIVE
JONESBORO AR
72401
US

V. Phone/Fax

Practice location:
  • Phone: 870-604-4600
  • Fax: 870-558-4191
Mailing address:
  • Phone: 870-604-4600
  • Fax: 870-558-4191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. SAVANAH STEWART
Title or Position: ORTHODONTIST
Credential: DDS, MS
Phone: 870-897-4277