Provider Demographics
NPI:1366573776
Name:STONE, JOHN H (DDS)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:H
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 1:575 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-2307
Mailing Address - Country:US
Mailing Address - Phone:847-446-0970
Mailing Address - Fax:847-446-0979
Practice Address - Street 1:575 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:WINNETKA
Practice Address - State:IL
Practice Address - Zip Code:60093-2307
Practice Address - Country:US
Practice Address - Phone:847-446-0970
Practice Address - Fax:847-446-0979
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL19A149911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice