Petr Vaughan, DDS, LLC

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

Legal business name

PETR VAUGHAN, DDS, LLC

Doing business as

Westside Pediatric Dentistry

Practice address

6558 Glenway Ave
Cincinnati, OH 45211-4410

Phone

(937) 245-0390

NPI assigned

Sep 30, 2022

Organization subpart

No

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

Authorized official

Name

Petr Alexander Vaughan, DDSNPI 1316576556

Title

Owner/President

Phone

(937) 245-0390

Specialties & licenses 2

Addresses

Other names 1

• Westside Pediatric Dentistry Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Petr Alexander Vaughan

  • Pediatric Dentistry
  • Cincinnati, OH
  • NPI 1316576556
  NPD Authorized official

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

{
    "created_epoch": "1664496000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1664496000000",
    "number": "1326762550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5310 WAKEFIELD PL",
            "city": "NORWOOD",
            "state": "OH",
            "postal_code": "452121737",
            "telephone_number": "937-245-0390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6558 GLENWAY AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452114410",
            "telephone_number": "937-245-0390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETR VAUGHAN, DDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-30",
        "last_updated": "2022-09-30",
        "certification_date": "2022-09-30",
        "status": "A",
        "authorized_official_last_name": "VAUGHAN",
        "authorized_official_first_name": "PETR",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "937-245-0390",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Westside Pediatric Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Susan Peterson, OTR
• Susan Thayer Peterson, CPRS
• Lisa Kay Petiniot, M.D.
• Alexandra P Petit
• Elena Petkovska, MD
• Petra Medicare Transportation LLC
• Vanessa Ann Petranek
• Jessica Sue Petre, MSW, LISW
• Haley Petrey, OTR/L
• Lisa Jayne Petrey, B.A,

• Pediatric Dentistry in Cincinnati, OH
• Providers in Cincinnati, OH by specialty
• Pediatric Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2022; 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.