Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1710688932 Individual Practitioner Male Practitioner

Dani Stanbouly

Dentist - General Practice • Mattapan, MA

Professional Overview & Biography Verified Profile Summary

Dani Stanbouly is a registered healthcare professional specializing in Dentist - General Practice in Mattapan, MA. Practice services are available at 542 RIVER STREET under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

542 River Street

Mattapan, MA 02126

Telephone 6173229773
Associated Practice Facility / Clinic
🏢 Dr. Dongwon Kim Pc Facility NPI 1740955723

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Mattapan, MA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.9 Yrs
Regional Practice Density
9 Specialists

Practicing in Mattapan, MA (3722 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-10-24
Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License MA DN10000425

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1184452088

Doctor of Dental Surgery

NPI 1912697335

Doctor of Dental Medicine

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
📍
Updated Practice Location October 29, 2024

Registered at 542 RIVER STREET, MATTAPAN, MA 02126 (Tel: 6173229773)

📍
Updated Business Mailing Address October 29, 2024

Registered at 542 RIVER STREET, MATTAPAN, MA 02126 (Tel: 6173229773)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 29, 2024

Dentist (License #DN10000425 in MA)

NPI Profile Active March 14, 2023

NPI status registered as active in NPPES database

📍
Updated Practice Location March 14, 2023

Registered at 622 W 168TH ST, NEW YORK, NY 100323720 (Tel: 2123056100)

📍
Updated Business Mailing Address March 14, 2023

Registered at 622 W 168TH ST, NEW YORK, NY 100323720 (Tel: 2123056100)

👤
Provider Name / Credentials Updated March 14, 2023

Recorded as DANI STANBOULY

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 14, 2023

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 14, 2023

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1710688932
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 14, 2023
Last Update: October 29, 2024
Sole Proprietor: No

Mailing Address

542 River Street

Mattapan, MA 02126

Phone: 6173229773

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.