Individual provider Active NPI

Theresa Sarah Petronzio, DDS

  • General Practice Dentistry
  • Albion, MI
National Provider Identifier
1013806702
Registry record updated Jun 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2901602639 Issued in MI
Practice address
1313 E Michigan Ave
Albion, MI 49224-2902
Phone
(517) 629-9107
NPI assigned
Jun 30, 2025
Last updated
Jun 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901602639 MI Primary

Addresses

Primary practice location

1313 E Michigan Ave
Albion, MI 49224-2902

Mailing address

2776 Sagebrush Cir Apt 202
Ann Arbor, MI 48103-8777
Phone (440) 476-1902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2901602639MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Stahl Family Dentistry PLLC General Practice CurrentSince Jul 9, 2025 Accepting new patients

Locations

1313 E Michigan Ave
Albion, MI 49224
Phone (517) 629-9107

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1751241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1751241600000",
    "number": "1013806702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2776 SAGEBRUSH CIR APT 202",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481038777",
            "telephone_number": "440-476-1902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 E MICHIGAN AVE",
            "city": "ALBION",
            "state": "MI",
            "postal_code": "492242902",
            "telephone_number": "517-629-9107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRONZIO",
        "first_name": "THERESA",
        "middle_name": "SARAH",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-06-30",
        "last_updated": "2025-06-30",
        "certification_date": "2025-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901602639",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Albion, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.