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Contact Information

DR. KENNETH J. STAVISKY, LTD.
99 SWIFT ST
SUITE 115
SOUTH BURLINGTON, VT05403-7303
 Phone: 802-865-1212
 Fax: 802-865-4666
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Endodontics

1223E0200X
Indicates primary specialty

NPI Profile & details for DR. KENNETH J. STAVISKY, LTD.

NPI Number 1942384979
LBN Legal business name DR. KENNETH J. STAVISKY, LTD.
Authorized official MARTHA PHILBRICK - (OFFICE MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 10/25/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
VT License # 01600001242
VT Other 1962512038 INDIVIDUAL NPI
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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