David S Petrik DDS PA

Primary specialty

DentistTaxonomy code 122300000X

License

DN 13150 Issued in FL

Legal business name

DAVID S PETRIK DDS PA

Practice address

1760 N Fort Harrison Ave
Clearwater, FL 33755-1706

Phone

(727) 442-4646

Fax

(727) 442-3542

NPI assigned

Nov 15, 2006

Organization subpart

No

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

Authorized official

Name

David S Petrik, DDS

Title

President of Corporation

Phone

(727) 442-4646

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1508939927",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 N FORT HARRISON AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337551706",
            "telephone_number": "727-442-4646",
            "fax_number": "727-442-3542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 N FORT HARRISON AVE",
            "city": "CLEARWATER",
            "state": "FL",
            "postal_code": "337551706",
            "telephone_number": "727-442-4646",
            "fax_number": "727-442-3542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID S PETRIK DDS PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PETRIK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT OF CORPORATION",
        "authorized_official_telephone_number": "727-442-4646",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN 13150",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Clearwater, FL
• Providers in Clearwater, FL by specialty
• Dentist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.