Individual provider Active NPI

Paula Petrone, RDH-BS OMT

  • Dental Hygienist
  • East Norwich, NY
National Provider Identifier
1023693348
Registry record updated Mar 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental HygienistTaxonomy code 124Q00000X
License
025978 Issued in NY
Practice address
142 Radcliff Dr
East Norwich, NY 11732-1225
Phone
(516) 260-8160
NPI assigned
Mar 17, 2021
Last updated
Mar 17, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 17, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Hygienist 124Q00000X 025978 NY Primary

Addresses

Primary practice location

142 Radcliff Dr
East Norwich, NY 11732-1225

Mailing address

142 Radcliff Dr
East Norwich, NY 11732-1225
Phone (516) 260-8160

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
025978NYMDDental Hygienist

NPI Registry JSON

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

{
    "created_epoch": "1615939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615939200000",
    "number": "1023693348",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 RADCLIFF DR",
            "city": "EAST NORWICH",
            "state": "NY",
            "postal_code": "117321225",
            "telephone_number": "516-260-8160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 RADCLIFF DR",
            "city": "EAST NORWICH",
            "state": "NY",
            "postal_code": "117321225",
            "telephone_number": "516-260-8160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRONE",
        "first_name": "PAULA",
        "name_prefix": "Mrs.",
        "credential": "RDH-BS OMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-17",
        "last_updated": "2021-03-17",
        "certification_date": "2021-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "NY",
            "license": "025978",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Norwich, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2021; 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.