Boris Stabnikov, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DEN02619 Issued in RI

Practice address

150 Social St
Suite 2
Woonsocket, RI 02895-3133

Phone

(401) 597-5077

Fax

(401) 597-5077

NPI assigned

Mar 1, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760510044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "341 S MAIN ST",
            "city": "SHARON",
            "state": "MA",
            "postal_code": "020671813",
            "telephone_number": "401-648-5570"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 SOCIAL ST",
            "address_2": "SUITE 2",
            "city": "WOONSOCKET",
            "state": "RI",
            "postal_code": "028953133",
            "telephone_number": "401-597-5077",
            "fax_number": "401-597-5077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STABNIKOV",
        "first_name": "BORIS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": "DEN02619",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "19214",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MASS HEALTH",
            "identifier": "0280283",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8055-2",
            "state": "RI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sripathi a.S. Karanth, MD, Inc
• Sooraj Srirangadhamu Gopu
• Anne St Cyr
• Brandon St. Pierre, LCSW
• Sarah-Lynn St. Vincent
• Carolyn Stark, PT
• Patricia Jean Stark, NPP
• Kathleen M Staudinger, MD
• Alexander Steacy, DPT
• Charles Stebbins, MA, COUNSELOR

• General Practice Dentistry in Woonsocket, RI
• Providers in Woonsocket, RI by specialty
• General Practice Dentistry in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.