Healthcare Provider Details

I. General information

NPI: 1174428205
Provider Name (Legal Business Name): STABILE, DIRENZO, AND CAPETILLO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2026
Last Update Date: 10/09/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8740 E MARKET STREET SUITE 1
WARREN OH
44484
US

IV. Provider business mailing address

8740 E MARKET STREET SUITE 1
WARREN OH
44484
US

V. Phone/Fax

Practice location:
  • Phone: 330-856-9989
  • Fax: 330-856-2030
Mailing address:
  • Phone: 330-856-9989
  • Fax: 330-856-2030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number StateNULL

VIII. Authorized Official

Name: DR. JEREMY CAPETILLO
Title or Position: ENDODONTIST
Credential: DDS, MS
Phone: 330-856-9989