FORT STEWART DENTAC (NPI# 1437500220) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437500220 |
| Entity Type | Organization |
| Organization Name | FORT STEWART DENTAC |
| Practice Address |
1061 Harmon Ave Fort Stewart GA 31314-5641 |
| Mailing Address |
343 Warrior Road Fort Stewart GA 31314 |
| Practice Telephone | 9123123352 |
| Mailing Telephone | 9123123352 |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-23 |
| Authorized Official Name | GLENDA ANN WITHERS (REGISTERED DENTAL HYGIENIST) |
| Authorized Official Telephone | 9123123352 |
| Authorized Official Credential | RDH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2865X1600X |
Military Hospital Specialization: Military General Acute Care Hospital. Operational (Transportable) |
DH009363 | GA | Hospitals |
| Street Address |
1061 HARMON AVE |
| City | FORT STEWART |
| State | GA |
| Zip Code | 31314-5641 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871596486 | Donald E Shackleford | Obstetrics & Gynecology | 1061 Harmon Ave, Fort Stewart, GA 31314 | 2005-05-27 |
| 1619575081 | Rudy Noel Torres Negron | Social Worker | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-10-16 |
| 1629675434 | Darryl B Moore | Counselor | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-10-05 |
| 1093330268 | Lesheia Tasker | Technician, Other | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-06-12 |
| 1770111270 | Kendal Padgett | Physical Therapist | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-30 |
| 1104452218 | Tiffany L Stark | Physician Assistant | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-20 |
| 1396371035 | Alicia Nichole Hasquin | Physician Assistant | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-13 |
| 1407481492 | Matthew Douglas Lueders | Student in an Organized Health Care Education/Training Program | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-10 |
| 1316572308 | Seth Ravid | Student in an Organized Health Care Education/Training Program | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-10 |
| 1487289526 | Huon Sharpe | Student in an Organized Health Care Education/Training Program | 1061 Harmon Ave, Fort Stewart, GA 31314-5641 | 2020-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932733995 | Heather Ziccarelli Deneen | Dietitian, Registered | 441 Bultman Ave, 1183, Fort Stewart, GA 31314 | 2020-02-28 |
| 1073099826 | Ross Emerick | Dentist | 351 West 6th Street, Fort Stewart, GA 31314 | 2018-07-16 |
| 1184154742 | Roland Garcia | Dentist | 351 W 6th St Bldg 440, Ft Stewart, GA 31314 | 2017-06-15 |
| 1548613045 | Sylvia Mclean | Dental Hygienist | 343 Vanguard Road, Fort Stewart, GA 31314 | 2016-07-20 |
| 1407209257 | David Wald Jr. | Dental Hygienist | 305 Vanguard Rd. Bldg 8335, Fort Stewar, GA 31314 | 2016-07-18 |
| 1376995415 | Alisha Potter | Dental Assistant | 305 Vangurard Road, Ft Stewart, GA 31314 | 2016-07-12 |
| 1538511068 | Brandi Harris | Dental Assistant | 305 Vanguard Rd, Ft Stewart, GA 31314 | 2016-07-08 |
| 1548612088 | Adrian Cuthbert | Dental Assistant | 305 Vanguard Road, Bldg 8435, Fort Stewart, GA 31314 | 2016-07-08 |
| 1841642386 | Beverly Lynn Berry | Dental Assistant | 306 Vanguard Road Bldg 8435, Fort Stewart, GA 31314 | 2016-07-08 |
| 1740630060 | Anjanette Nicole' Brown | Dental Assistant | 706 Warriors Rd, Building 2115, Fort Stewart, GA 31314 | 2016-06-17 |
| Find all providers in zip 31314 | ||||
| Taxonomy Code | 2865X1600X |
| Grouping | Hospitals |
| Classification | Military Hospital |
| Specialization | Military General Acute Care Hospital. Operational (Transportable) |
| A Department of Defense (DoD) health care organization furnishing inpatient care 24 hours per day in "non-fixed" or deployed facilities. Entity is not Defense Health Program funded. Services are primarily intended for DoD active duty though some services may be furnished for non-DoD active duty. "Non-fixed" facilities are generally deployed DoD health care activities, not providing services on or in association with a DoD fort or base. "Non-fixed" facilities include hospital ships. |
| Notes: [1/1/2005: title modified, definition added] |
| City | FORT STEWART |
| Zip Code | 31314 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.