Station Dental Associates Inc.

Primary specialty

DentistTaxonomy code 122300000X

License

039610 Issued in NY

Legal business name

STATION DENTAL ASSOCIATES INC.

Practice address

177 Old Country Rd
Riverhead, NY 11901-2102

Phone

(631) 208-3068

Fax

(631) 208-3137

NPI assigned

Mar 18, 2008

Organization subpart

Yes

Parent organization

STATION DENTAL ASSOCIATES INC.As reported in NPPES

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

Authorized official

Name

Mr. Sheldon Gary Milo, DDS

Title

Owner

Phone

(516) 448-4652

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Station Associates Inc Other name

Part of

Station Dental Associates Inc

Locations

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

{
    "created_epoch": "1205798400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1469491200000",
    "number": "1366613317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "177 OLD COUNTRY RD",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012102",
            "telephone_number": "631-208-3068",
            "fax_number": "631-208-3137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "177 OLD COUNTRY RD",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012102",
            "telephone_number": "631-208-3068",
            "fax_number": "631-208-3137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STATION DENTAL ASSOCIATES INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "STATION DENTAL ASSOCIATES INC.",
        "enumeration_date": "2008-03-18",
        "last_updated": "2016-07-26",
        "status": "A",
        "authorized_official_last_name": "MILO",
        "authorized_official_first_name": "SHELDON",
        "authorized_official_middle_name": "GARY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-448-4652",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NY",
            "license": "039610",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "045455",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "039610",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02672402",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Station Associates Inc",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Johanna St Jean, LMSW
• Kerri Michaela Stafford
• Donald D Staiano
• Lee William Stambouli
• Mary Stark
• Lilly Steel, MD
• Arielle Joy Stein, CCC-SLP
• Jerry Steiner
• Katherine Stenby
• Bibiana D Stephen, MD

• Dentist in Riverhead, NY
• Providers in Riverhead, NY by specialty
• Dentist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2016; 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.