Provider Demographics
NPI:1902959869
Name:STONE, WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:
Last Name:STONE
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21441 42ND AVE
Mailing Address - Street 2:STE. 2C
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11361-2963
Mailing Address - Country:US
Mailing Address - Phone:718-423-8797
Mailing Address - Fax:718-423-8701
Practice Address - Street 1:21441 42ND AVE
Practice Address - Street 2:STE. 2C
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-2963
Practice Address - Country:US
Practice Address - Phone:718-423-8797
Practice Address - Fax:718-423-8701
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0262601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00285676Medicaid