Peter M Listro, DMD, PC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

DS018695L Issued in PA

Legal business name

PETER M LISTRO, DMD, PC

Practice address

1020 Thompson St
Jersey Shore, PA 17740-1729

Phone

(570) 398-0100

NPI assigned

Nov 1, 2007

Last updated

Oct 6, 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. Peter M Listro, DMD

Title

President

Phone

(800) 883-7243

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1193875200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254787200000",
    "number": "1598944969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 N TUSTIN AVE",
            "city": "SANTA ANA",
            "state": "CA",
            "postal_code": "927053807",
            "telephone_number": "714-347-1000",
            "fax_number": "714-647-1245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1020 THOMPSON ST",
            "city": "JERSEY SHORE",
            "state": "PA",
            "postal_code": "177401729",
            "telephone_number": "570-398-0100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER M LISTRO, DMD, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-01",
        "last_updated": "2009-10-06",
        "status": "A",
        "authorized_official_last_name": "LISTRO",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "800-883-7243",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "DS018695L",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Jersey Shore, PA
• Providers in Jersey Shore, PA by specialty
• Anesthesiology Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.