IndividualActive
Stefanus Siswanto, DDS
NPI 1033271879 · General Practice Dentistry · Dallas, TX
Provider details
- NPI number
- 1033271879
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- 22440 (TX)
Specialties & taxonomies
Dental Providers
Profile Score
Detailed profile(90/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
18181 Midway Rd Ste 500
Dallas, TX 75287-8104
Phone: (972) 306-5000
Fax: (972) 306-5009
Street-level locationGet directions
Mailing address
5304 Saint Croix Ct
Richardson, TX 75082-4134
Registry dates
- Enumerated
- 2006-12-15
- Last updated
- 2009-07-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.