Dennis Michael Petricoin Sr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DS017007 Issued in PA

Practice address

224 Oak Hill LN
Wyomissing, PA 19610-3215

Phone

(610) 374-9163

NPI assigned

Aug 23, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1156291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1588770176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 OAK HILL LN",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103215",
            "telephone_number": "610-374-9163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 OAK HILL LN",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196103215",
            "telephone_number": "610-374-9163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRICOIN",
        "first_name": "DENNIS",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS017007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rick Anthony Perez, MSW
• Ryanna Perez
• Christine Perilli, OTR
• Peter H. Thomasph.D. and Associates
• Tory R Peterson
• Makayla Dove Pfister
• Jessica A Pham, MA RD LDN
• Phoenix Wellness LLC (Cicely Holston Counseling)
• Barbara Jeanne Piazza, PHD
• Guy N Piegari Jr., MD

• General Practice Dentistry in Wyomissing, PA
• Providers in Wyomissing, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.