MEDICARE: DR. JOHN-MICHAEL STEWART DMD

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	19330	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1497719751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN-MICHAEL STEWART DMD

Provider Business Mailing Address
First Line	:	8611 HILLCREST AVE
Second Line	:	STE 235
City	:	DALLAS
State	:	TX
Zip	:	75225-4203
Country	:	US
Telephone Number	:	214-269-1244
Fax Number	:	214-269-1245

Provider Business Practice Location Address
First Line	:	8611 HILLCREST AVE
Second Line	:	STE 235
City	:	DALLAS
State	:	TX
Zip	:	75225-4203
Country	:	US
Telephone Number	:	214-269-1244
Fax Number	:	214-269-1245

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

Provider Enumeration Date	:	04/13/2006
Last Update Date	:	04/10/2015

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