Anthony G. Petrilli, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

049131 Issued in NY

Practice address

348 Abbott Rd
Buffalo, NY 14220-1602

Phone

(716) 823-3030

NPI assigned

Nov 30, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

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

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1396310400000",
    "number": "1215004452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "348 ABBOTT RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142201602",
            "telephone_number": "716-823-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 ABBOTT RD",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142201602",
            "telephone_number": "716-823-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRILLI",
        "first_name": "ANTHONY",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2014-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "049131",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02658304",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dina Petrella
• Heather Petri
• Jeanenne Petri, PMHNP-BC
• April Petrik, FNP-BC
• Gail Marie Petrille, R.N.
• Laura Testa Petrocelli, LMSW
• Lauren Petrocelli, LCSW
• Alex A Petrosian, M.D.
• Michael Petroziello, MD
• Mariah Lee Petrusek, R.D.N.

• General Practice Dentistry in Buffalo, NY
• Providers in Buffalo, NY by specialty
• General Practice Dentistry in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2014; 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.