Byrde Pettigrew, D.M.D

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

DI013839 Issued in NJ

Practice address

50 W Black Horse Pike
Pleasantville, NJ 08232-2645

Phone

(609) 641-1065

Fax

(609) 645-0162

NPI assigned

Dec 15, 2005

Sex

Female

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

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 and National Provider Directory roles.

• Mainland Dental Associates

  • General Practice Dentistry
  • Pleasantville, NJ
  • NPI 1497891188
  NPD (past)

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

{
    "created_epoch": "1134604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245216985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1013 HEARTWOOD DR",
            "city": "CHERRY HILL",
            "state": "NJ",
            "postal_code": "080033246",
            "telephone_number": "609-641-1065",
            "fax_number": "609-645-0162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 W BLACK HORSE PIKE",
            "city": "PLEASANTVILLE",
            "state": "NJ",
            "postal_code": "082322645",
            "telephone_number": "609-641-1065",
            "fax_number": "609-645-0162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTIGREW",
        "first_name": "BYRDE",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "NJ",
            "license": "DI013839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Teresa O'Brien, DMD
• Deborah Osei-Agyeman
• Shivam A Parikh, PHARMD
• Paul H. Goodman, D.D.S. and Jay L. Rosenberg, D.D.S., L.L.C.
• Charles Keeler Paxson, DMD
• Phoenix Recovery House
• Dwayne J Pierce Sr.
• Pleasant Care Pharmacy Inc
• Pleasantech Academy Charter School
• Pleasantville Board of Education

• All providers in Pleasantville, NJ
• Pediatric Dentistry in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.