Provider Demographics
NPI:1700555190
Name:STEWART, ALANNA (DDS)
Entity Type:Individual
Prefix:
First Name:ALANNA
Middle Name:
Last Name:STEWART
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 STATE HIGHWAY 78 STE 200
Mailing Address - Street 2:
Mailing Address - City:LAVON
Mailing Address - State:TX
Mailing Address - Zip Code:75166-1277
Mailing Address - Country:US
Mailing Address - Phone:972-853-2100
Mailing Address - Fax:
Practice Address - Street 1:410 STATE HIGHWAY 78 STE 200
Practice Address - Street 2:
Practice Address - City:LAVON
Practice Address - State:TX
Practice Address - Zip Code:75166-1277
Practice Address - Country:US
Practice Address - Phone:972-853-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-09
Last Update Date:2023-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA72211223G0001X
TX378041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice