DR. KENNETH J. STAVISKY, LTD. (NPI# 1942384979) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942384979 |
| Entity Type | Organization |
| Organization Name | DR. KENNETH J. STAVISKY, LTD. |
| Practice Address |
99 Swift St Suite 115 South Burlington VT 05403-7303 |
| Practice Telephone | 8028651212 |
| Practice Fax Number | 8028654666 |
| Mailing Telephone | 8028651212 |
| Mailing Fax Number | 8028654666 |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. MARTHA WHITCOMB PHILBRICK (OFFICE MANAGER) |
| Authorized Official Telephone | 8028651212 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223E0200X |
Dentist Specialization: Endodontics |
01600001242 | VT | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VT | INDIVIDUAL NPI | 1962512038 | 01 |
| Street Address |
99 SWIFT ST SUITE 115 |
| City | SOUTH BURLINGTON |
| State | VT |
| Zip Code | 05403-7303 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962512038 | Kenneth Joseph Stavisky | Dentist | 99 Swift St, Suite 115, South Burlington, VT 05403-7324 | 2006-08-30 |
| 1689893729 | Peggy S Lindsey | Ophthalmology | 99 Swift St, Suite 200, South Burlington, VT 05403-7303 | 2007-04-25 |
| 1215068770 | Retina Center of Vermont, Inc | Ophthalmology | 99 Swift St, Suite 200, South Burlington, VT 05403-7303 | 2007-03-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659938975 | Josee-ann Guay | Student in an Organized Health Care Education/Training Program | 1060 Hinesburg Road Suite 201, South Burlington, VT 05403 | 2019-05-22 |
| 1821556390 | Alexander Taite Carpenter | Specialist/Technologist | 2069 Williston Road Ap #2, South Burlington, VT 05403 | 2019-03-04 |
| 1144732785 | Molly Koch Parker | Dietitian, Registered | 1233 Shelburne Rd Ste D2, South Burlington, VT 05403 | 2017-11-03 |
| 1497273007 | Marlena Anya Pecora | Acupuncturist | 368 Dorset St # 3, South Burlington, VT 05403 | 2017-09-03 |
| 1467908525 | Rinaben P Patel | Pharmacist | 39 Hinesburd Road, South Burlington, VT 05403 | 2016-08-29 |
| 1770949950 | Tara Flor | Chiropractor | 30 Farrell St Ste 100, South Burlington, VT 05403 | 2016-01-04 |
| 1356716187 | Frank Breen | Counselor | 163 Hinesburg Road, South Burlington, VT 05403 | 2015-12-04 |
| 1063808210 | Lisa C Harrington | Registered Nurse | Stone House Associates, 27 Rye Circle, South Burlington, VT 05403 | 2015-04-14 |
| 1083018626 | Jessica Jablonski | Speech-Language Pathologist | 2 Baldwin Ave, South Burlington, VT 05403 | 2014-10-10 |
| 1538590567 | Vasta Physical Therapy, Inc | Physical Therapist | 340 Dorset Street, Suite 2, South Burlington, VT 05403 | 2013-12-02 |
| Find all providers in zip 05403 | ||||
| Taxonomy Code | 1223E0200X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Endodontics |
| The branch of dentistry that is concerned with the morphology, physiology and pathology of the human dental pulp and periradicular tissues. Its study and practice encompass the basic and clinical sciences including biology of the normal pulp, the etiology, diagnosis, prevention and treatment of diseases and injuries of the pulp and associated periradicular conditions. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285727230 | John Andrew Pane | Dentist | 45 Timber Lane, South Burlington, VA 05403 | 2006-10-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487876371 | Arthur William Harris | Dentist | 22 E View Ln, Suite B, Barre, VT 05641-5317 | 2007-05-02 |
| 1346332582 | Victor L Ratkus | Dentist | 227 Colchester Ave, Burlington, VT 05401-1411 | 2006-09-28 |
| 1275648487 | Vermont Endodontics Pllc | Dentist | 75 Talcott Road, Suite 20, Williston, VT 05495 | 2006-08-20 |
| 1750724084 | Dr, Victor L. Ratkus, Dds, PC | Dentist | 227 Colchester Ave, Burlington, VT 05401-1411 | 2013-04-17 |
| 1083989289 | Charles Alexander Ullman | Dentist | 71 Allen St, Sutie 204, Rutland, VT 05701-4570 | 2012-03-21 |
| 1457638892 | Upper Valley Endodontics | Dentist | 205 Billings Farm Rd, Suite 6a, White River Junction, VT 05001-5400 | 2011-11-14 |
| 1184892309 | Brooke Blicher | Dentist | 205 Billings Farm Rd, Suite 6a, White River Junction, VT 05001-5400 | 2008-02-11 |
| 1558483321 | Southern Vermont Endontics, PC | Dentist | 71 Allen St, Suite 204, Rutland, VT 05701-4570 | 2007-04-04 |
| 1619097268 | Lee Ann Petropulos Whelan | Dentist | 75 Talcott Rd, Suite 20, Williston, VT 05495-8121 | 2007-03-29 |
| 1629198288 | Maribel Barria | Dentist | 75 Talcott Rd, Suite 20, Williston, VT 05495-8121 | 2007-03-29 |
| Find all providers with the same taxonomy | ||||
| City | SOUTH BURLINGTON |
| Zip Code | 05403 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.