Georgi P Petrov, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9474 Issued in NC

Practice address

1212 Freeway Dr
Reidsville, NC 27320-7170

Phone

(336) 342-0102

NPI assigned

May 16, 2013

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Dr. Jeff Wayne Johnson DDS

  • General Practice Dentistry
  • Reidsville, NC
  • NPI 1790953776
  NPD (past)

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

{
    "created_epoch": "1368662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1134565286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 SAINT JAMES ST",
            "address_2": "APT. 3",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152322169",
            "telephone_number": "919-200-0377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1212 FREEWAY DR",
            "city": "REIDSVILLE",
            "state": "NC",
            "postal_code": "273207170",
            "telephone_number": "336-342-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROV",
        "first_name": "GEORGI",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-16",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "9474",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pelican Health Reidsville LLC
• Rebekah Pennington, PA
• Qua'Shawn Pernell, BSW, MSW, LCSWA
• Peter Grumbos DDS Reidsville PLLC
• Emily Carter Petersen, MA
• Physical Therapy and Hand Specialist, LLC
• Piedmont Occupational & General Medicine
• Piedmont Podiatry Associates, PLLC
• Piedmont Stone Center
• Laurie Pontonero, OTR/L

• General Practice Dentistry in Reidsville, NC
• Providers in Reidsville, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.