Provider Demographics
NPI:1518014034
Name:STINGLEY, KEVIN J (DDS)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:J
Last Name:STINGLEY
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 1:129 CRESCENT CT
Mailing Address - Street 2:
Mailing Address - City:MONTICELLO
Mailing Address - State:IA
Mailing Address - Zip Code:52310-1801
Mailing Address - Country:US
Mailing Address - Phone:319-480-6395
Mailing Address - Fax:
Practice Address - Street 1:1690 ELM ST STE 300
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-3679
Practice Address - Country:US
Practice Address - Phone:563-690-2850
Practice Address - Fax:563-690-0349
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IADDS-06831122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0030759Medicaid