Provider Demographics
NPI:1083756225
Name:PLUNKA, STANLEY MARVIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:MARVIN
Last Name:PLUNKA
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 1:8890 MCDONOGH RD STE 315
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5453
Mailing Address - Country:US
Mailing Address - Phone:410-484-1010
Mailing Address - Fax:410-486-8939
Practice Address - Street 1:8890 MCDONOGH RD STE 315
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5453
Practice Address - Country:US
Practice Address - Phone:410-971-1063
Practice Address - Fax:410-486-8939
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2023-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD07854122300000X
MDMD0785451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD48082Medicaid
MD48082Medicaid
MDT59481Medicare UPIN