Antonia Petrosino, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

19-026036 Issued in IL

Practice address

818 N 19TH Ave
Melrose Park, IL 60160-3726

Phone

(708) 450-1170

Fax

(708) 450-0008

NPI assigned

Jun 30, 2008

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dimoulis Dental P.C.

  dba The Dental Office At Melrose Park

  • General Practice Dentistry
  • Melrose Park, IL
  • NPI 1811362791
  NPD (past)

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

{
    "created_epoch": "1214784000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214784000000",
    "number": "1184886244",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "818 N 19TH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601603726",
            "telephone_number": "708-450-1170",
            "fax_number": "708-450-0008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "818 N 19TH AVE",
            "city": "MELROSE PARK",
            "state": "IL",
            "postal_code": "601603726",
            "telephone_number": "708-450-1170",
            "fax_number": "708-450-0008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROSINO",
        "first_name": "ANTONIA",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-06-30",
        "last_updated": "2008-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "19-026036",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vicente Perez
• Dana C. Perry, M.D.
• Peter E Eupierre M.D P.C
• Megan Leigh Peterson, MA, CCC-SLP
• Melissa Petkovic
• Suzanne Thi Pham, M.D.
• Leena Philip
• Elise Ann Piagentini, CCC-SLP
• Scott M. Pierce, M.D.
• Pilsen-Little Village Community Mental Health Center, Inc

• General Practice Dentistry in Melrose Park, IL
• Providers in Melrose Park, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2008; 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.