Petito Oral Surgery

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

2552 Issued in RI

Legal business name

PETITO ORAL SURGERY

Practice address

400 Massasoit Ave
Suite 103
East Providence, RI 02914-2012

Phone

(401) 578-1866

Fax

(508) 336-6580

NPI assigned

Jun 17, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Anthony Rocco Petito, DDS MD

Title

Owner

Phone

(401) 578-1688

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1308268800000",
    "number": "1134414154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 MASSASOIT AVE",
            "address_2": "SUITE 103",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029142012",
            "telephone_number": "401-578-1866",
            "fax_number": "508-336-6580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 MASSASOIT AVE",
            "address_2": "SUITE 103",
            "city": "EAST PROVIDENCE",
            "state": "RI",
            "postal_code": "029142012",
            "telephone_number": "401-578-1866",
            "fax_number": "508-336-6580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETITO ORAL SURGERY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-06-17",
        "last_updated": "2011-06-17",
        "status": "A",
        "authorized_official_last_name": "PETITO",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "ROCCO",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "401-578-1688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "RI",
            "license": "2552",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKenzie Grace Perkins
• Susan Perlini, RDH, PHDH
• Jessica Gomes Lopes Perry, MSW, LCSW
• Olivia Perry, PA-C
• Sara Petit
• Anthony Rocco Petito, DDS, MD
• David J Pezzullo, PT
• Shelby Pezzullo, PT
• Danielle Marie Phaneuf
• Eric A Phillips, PT

• Dental Clinic/Center in East Providence, RI
• Providers in East Providence, RI by specialty
• Dental Clinic/Center in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2011; 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.