Active NPI
Elena Petrova, DDS
- Pediatric Dentistry
- Sarasota, FL
National Provider Identifier
1225457054
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN21853
- Practice address
- 3103 Fruitville Rd
Sarasota, FL 34237-5341 - Phone
- (941) 953-2111
- NPI assigned
- Apr 9, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DN21853 | FL | Primary |
Addresses
Primary practice location
3103 Fruitville Rd
Sarasota, FL 34237-5341
Mailing address
3103 Fruitville Rd
Sarasota, FL 34237-5341
Phone (941) 953-2111
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
| License | State | Type | Specialty |
|---|---|---|---|
| DN21853 | FL | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Manav Malik DMD, PA | Pediatric Dentistry | Past | Accepting new patients |
| TDN Dentistry PLLC | Pediatric Dentistry | Past | Accepting new patients |
Organizations & group practices 2
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397001600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468195200000",
"number": "1225457054",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3103 FRUITVILLE RD",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342375341",
"telephone_number": "941-953-2111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3103 FRUITVILLE RD",
"city": "SARASOTA",
"state": "FL",
"postal_code": "342375341",
"telephone_number": "941-953-2111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETROVA",
"first_name": "ELENA",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-04-09",
"last_updated": "2016-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "FL",
"license": "DN21853",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sarasota, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.