Petit Dermatology LLC

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

Legal business name

PETIT DERMATOLOGY LLC

Practice address

6770 Cincinnati Dayton Rd Ste 200
Liberty Township, OH 45044-9319

Phone

(330) 575-4674

NPI assigned

Jul 8, 2024

Organization subpart

No

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

Authorized official

Name

Danielle Petit, MDNPI 1841532348

Title

Owner

Phone

(330) 575-4674

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

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

• Danielle Petit, M.D.

  • Dermatology Physician
  • Liberty Township, OH
  • NPI 1841532348
  Medicare reassignment Care Compare group NPD Authorized official
• Kristin Petit, MD

  • Dermatology Physician
  • Liberty Township, OH
  • NPI 1114667581
  Care Compare group NPD

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

{
    "created_epoch": "1720396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724025600000",
    "number": "1447096540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6770 CINCINNATI DAYTON RD STE 200",
            "city": "LIBERTY TOWNSHIP",
            "state": "OH",
            "postal_code": "450449319",
            "telephone_number": "330-575-4674"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6770 CINCINNATI DAYTON RD STE 200",
            "city": "LIBERTY TOWNSHIP",
            "state": "OH",
            "postal_code": "450449319",
            "telephone_number": "330-575-4674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "121 Forrer Blvd",
            "address_purpose": "LOCATION",
            "city": "Oakwood",
            "state": "OH",
            "postal_code": "454193137",
            "country_code": "US",
            "telephone_number": "330-575-4674",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PETIT DERMATOLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-08",
        "last_updated": "2024-08-19",
        "certification_date": "2024-08-19",
        "status": "A",
        "authorized_official_last_name": "PETIT",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "330-575-4674",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Usha M Pasupuleti, PTA
• Fenil Patel, MD
• Prutha Patel, PHARMD
• Blake Peters, M,A., CCC-SLP
• Melissa Peterson
• Danielle Petit, M.D.
• Kristin Petit, MD
• Misty Ann Petredis, LPN
• Jennifer Louise Pettit, M. ED., LPCC
• Amy Pham

• Dermatology Physician in Liberty Township, OH
• Providers in Liberty Township, OH by specialty
• Dermatology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.