Petra V. Enzien, DMD, PLLC

Primary specialty

Dental Clinic/CenterTaxonomy code 261QD0000X

License

046460 Issued in NY

Legal business name

PETRA V. ENZIEN, DMD, PLLC

Practice address

211 Park Ave
Mechanicville, NY 12118-1502

Phone

(518) 664-2500

Fax

(518) 664-2501

NPI assigned

Dec 19, 2009

Last updated

Dec 19, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Petra Victoria Enzien, DMDNPI 1336491224

Title

Owner

Phone

(518) 664-2500

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Petra V. Enzien, DMD

  • Dentist
  • Mechanicville, NY
  • NPI 1336491224
  NPD (past) Authorized official

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

{
    "created_epoch": "1261180800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1261180800000",
    "number": "1538498654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 PARK AVE",
            "city": "MECHANICVILLE",
            "state": "NY",
            "postal_code": "121181502",
            "telephone_number": "518-664-2500",
            "fax_number": "518-664-2501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 PARK AVE",
            "city": "MECHANICVILLE",
            "state": "NY",
            "postal_code": "121181502",
            "telephone_number": "518-664-2500",
            "fax_number": "518-664-2501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETRA V. ENZIEN, DMD, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-19",
        "last_updated": "2009-12-19",
        "status": "A",
        "authorized_official_last_name": "ENZIEN",
        "authorized_official_first_name": "PETRA",
        "authorized_official_middle_name": "VICTORIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "518-664-2500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NY",
            "license": "046460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Gerard O'Neil, P.T.
• Orthopedicsny, LLP (OrthoNY)
• Theresa Parascandola, MD
• Shilpkumar Patel, RPH
• Jan Louise Patterson, MD
• Laurie Phibbs, OTR/L
• Dana Lynn Pitaniello, M.S. CCC-SLP
• Debra L Prehoda, RN,BSN
• Marc David Price, D.O.
• Daniella A Reinoso-Gonzalez, M.S. ED.

• Dental Clinic/Center in Mechanicville, NY
• Providers in Mechanicville, NY by specialty
• Dental Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2009; 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.