Active NPI
Alison Petix
- Endodontics
- Hawthorne, NJ
National Provider Identifier
1548537129
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Endodontics
- License
- DI02142400
- Practice address
- 290 Lafayette Ave
Hawthorne, NJ 07506-1961 - Phone
- (973) 423-0789
- NPI assigned
- Nov 25, 2011
- Last updated
- Nov 25, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endodontics | 1223E0200X | DI02142400 | NJ | Primary |
Addresses
Primary practice location
290 Lafayette Ave
Hawthorne, NJ 07506-1961
Mailing address
290 Lafayette Ave
Hawthorne, NJ 07506-1961
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DI02142400 | NJ | MD | Endodontist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1322179200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1322179200000",
"number": "1548537129",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "290 LAFAYETTE AVE",
"city": "HAWTHORNE",
"state": "NJ",
"postal_code": "075061961"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "290 LAFAYETTE AVE",
"city": "HAWTHORNE",
"state": "NJ",
"postal_code": "075061961",
"telephone_number": "973-423-0789"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETIX",
"first_name": "ALISON",
"name_prefix": "Dr.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-11-25",
"last_updated": "2011-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "1223E0200X",
"taxonomy_group": "",
"desc": "Dentist, Endodontics",
"state": "NJ",
"license": "DI02142400",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hawthorne, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.