Provider Demographics
NPI:1194934174
Name:STABILE, RICHARD JOHN (DDS)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JOHN
Last Name:STABILE
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 MANITOU TRL
Mailing Address - Street 2:
Mailing Address - City:KINGS PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11754-4550
Mailing Address - Country:US
Mailing Address - Phone:631-223-2167
Mailing Address - Fax:
Practice Address - Street 1:7 HIGH ST
Practice Address - Street 2:209
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-7605
Practice Address - Country:US
Practice Address - Phone:631-673-8061
Practice Address - Fax:631-427-7350
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-22
Last Update Date:2025-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0246721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice