Dhafir Jalal Petros

Primary specialty

DentistTaxonomy code 122300000X

License

47154 Issued in CA

Practice address

4844 University Ave
Suit B
San Diego, CA 92105-8021

Phone

(619) 285-5010

Fax

(619) 285-5013

NPI assigned

May 25, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

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

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Petros.Toma&Putrus Dental Corp

  • General Practice Dentistry
  • San Diego, CA
  • NPI 1548320849
  NPD (past) Authorized official
• Petros Toma & Putrus Dental Corp

  • Dentist
  • San Diego, CA
  • NPI 1104988088
  NPD (past)

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346451812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4844 UNIVERSITY AVE",
            "address_2": "SUIT B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921058021",
            "telephone_number": "619-285-5010",
            "fax_number": "619-285-5013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4844 UNIVERSITY AVE",
            "address_2": "SUIT B",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921058021",
            "telephone_number": "619-285-5010",
            "fax_number": "619-285-5013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROS",
        "first_name": "DHAFIR",
        "middle_name": "JALAL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "47154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeanette Marie Petrini, LCSW
• Alex Petro, MSW, LCSW
• Anthony Petrone Jr., MA
• Vicki C Petropoulos, DMD, MS
• Petros Toma & Putrus Dental Corp
• Petros.Toma&Putrus Dental Corp
• Emilya Petrosyan
• Brandon Michael Petrovich, MD
• Irina Petrovich
• Dennis John Petrucci, A.T.C.

• Dentist in San Diego, CA
• Providers in San Diego, CA by specialty
• Dentist in California

• 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.
• 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.