Sofia D. Petrov, D.D.S., M.S.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

DE00008728 Issued in WA

Practice address

27081 185TH Ave SE Ste B-105
Covington, WA 98042-8448

Phone

(253) 981-4950

Fax

(253) 981-4952

NPI assigned

Nov 7, 2006

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.

• DMG Dental Design LLC

  • General Practice Dentistry
  • Bothell, WA
  • NPI 1508246927
  NPD (past)

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

{
    "created_epoch": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624838400000",
    "number": "1285703702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27081 185TH AVE SE",
            "address_2": "SUITE B-105",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980428448",
            "telephone_number": "253-981-4950",
            "fax_number": "253-981-4952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27081 185TH AVE SE STE B-105",
            "city": "COVINGTON",
            "state": "WA",
            "postal_code": "980428448",
            "telephone_number": "253-981-4950",
            "fax_number": "253-981-4952"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1908 201st Pl SE Apt 200",
            "address_purpose": "LOCATION",
            "city": "Bothell",
            "state": "WA",
            "postal_code": "980128572",
            "country_code": "US",
            "telephone_number": "425-488-2345",
            "fax_number": "425-489-4082",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETROV",
        "first_name": "SOFIA",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "D.D.S., M.S.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "DE00008728",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorraine Marie Pereira
• Perrigo Massage LLC
• Brenda Torres Perrigo
• Jessica Raelynn Petersen
• Kayla R Peterson, RDN, CEP
• Viet Quoc Pham
• Planted by the Water Counseling, PLLC
• Lori Poore, RPH
• Proliance Surgeons Inc P S
• Proliance Surgeons, Inc., P.S.

• Periodontics in Covington, WA
• Providers in Covington, WA by specialty
• Periodontics in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.