Dmitry Stillman, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DI19909 Issued in NJ

Practice address

45 Winant Avenue
Ridgefield Park, NJ 07660-1925

Phone

(201) 440-2100

Fax

(201) 440-1279

NPI assigned

Oct 17, 2005

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bergen Pediatric Dental, LLC

  • Pediatric Dentistry
  • Ridgefield Park, NJ
  • NPI 1235323825
  NPD (past) Authorized official
• ABA Pediatric, LLC

  • Pediatric Dentistry
  • Jersey City, NJ
  • NPI 1568686384
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216684800000",
    "number": "1275522880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 JOURNAL SQ",
            "address_2": "SUITE 601",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073064011",
            "telephone_number": "201-386-0353",
            "fax_number": "201-386-0356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 WINANT AVENUE",
            "city": "RIDGEFIELD PARK",
            "state": "NJ",
            "postal_code": "076601925",
            "telephone_number": "201-440-2100",
            "fax_number": "201-440-1279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STILLMAN",
        "first_name": "DMITRY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-17",
        "last_updated": "2008-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "DI19909",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Specialty RX Inc
• Specialty RX Inc
• Carlo O. Speziale, DC
• Steps Ahead Podiatry, LLC
• Kera Stillitano, APN
• Rada Sumareva, DDS
• Lourdes Mojica Sumilang, R.N.
• John Alfred Taltavall III, DMD
• Lawton Cross Thomas Jr., DMD
• Luis Fernando Torres

• Pediatric Dentistry in Ridgefield Park, NJ
• Providers in Ridgefield Park, NJ by specialty
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.