Healthcare Provider Details

I. General information

NPI: 1396608113
Provider Name (Legal Business Name): LOLIYA J. STEWART, DDS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 BILL KENNEDY WAY SE STE D-E
ATLANTA GA
30316-6847
US

IV. Provider business mailing address

245 N HIGHLAND AVE NE STE 230
ATLANTA GA
30307-2268
US

V. Phone/Fax

Practice location:
  • Phone: 404-850-3424
  • Fax: 404-850-3626
Mailing address:
  • Phone: 404-850-3424
  • Fax: 404-850-3626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. LOLIYA JOY STEWART
Title or Position: CEO
Credential: DDS
Phone: 404-850-3424