James Louis Petraitis, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DSO21328L Issued in PA

Practice address

5769 Saltsburg Rd
Verona, PA 15147-3211

Phone

(412) 795-5600

Fax

(412) 795-1172

NPI assigned

Nov 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487731451",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5769 SALTSBURG RD",
            "city": "VERONA",
            "state": "PA",
            "postal_code": "151473211",
            "telephone_number": "412-795-5600",
            "fax_number": "412-795-1172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5769 SALTSBURG RD",
            "city": "VERONA",
            "state": "PA",
            "postal_code": "151473211",
            "telephone_number": "412-795-5600",
            "fax_number": "412-795-1172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRAITIS",
        "first_name": "JAMES",
        "middle_name": "LOUIS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-01",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DSO21328L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IRS TIN",
            "identifier": "2561825027",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "DSO21328L",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Payne Russell
• Elizabeth Mayne Peace, LPC
• Morgan Peli
• Penn Hills Charter School of Entrepreneurship
• Thomas William Perka, O.D.
• Brandon Everett Phillips Sr., LPC
• Stacie Lynn Phillips
• Douglas Placais, PA
• Jamie Powers
• Janelle L Rademacher, PHARMD

• General Practice Dentistry in Verona, PA
• Providers in Verona, PA by specialty
• General Practice Dentistry in Pennsylvania

• 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.