Harvard Avenue Dental Care PA

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

18774 Issued in TX

Legal business name

HARVARD AVENUE DENTAL CARE PA

Practice address

3131 Harvard Avenue
Suite 107
Dallas, TX 75205

Phone

(214) 521-2258

Fax

(214) 521-3425

NPI assigned

Jan 23, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Lyle Paul Petrutsas, DDSNPI 1740429828

Title

Owner Dentist

Phone

(214) 521-2258

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.

• Lyle Petrutsas, DDS

  • Dentist
  • Dallas, TX
  • NPI 1740429828
  NPD (past) Authorized official

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207612800000",
    "number": "1659425759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3131 HARVARD AVENUE",
            "address_2": "SUITE 107",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75205",
            "telephone_number": "214-521-2258",
            "fax_number": "214-521-3425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3131 HARVARD AVENUE",
            "address_2": "SUITE 107",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "75205",
            "telephone_number": "214-521-2258",
            "fax_number": "214-521-3425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HARVARD AVENUE DENTAL CARE PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-23",
        "last_updated": "2008-04-08",
        "status": "A",
        "authorized_official_last_name": "PETRUTSAS",
        "authorized_official_first_name": "LYLE",
        "authorized_official_middle_name": "PAUL",
        "authorized_official_title_or_position": "OWNER DENTIST",
        "authorized_official_telephone_number": "214-521-2258",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "18774",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sloane Hartzell, PHARMD
• Whitney Hartzell, LCSW
• Lauren Hartzler, PA-C
• Jhanilka Hartzog, LPC
• Ruzanna Harutyunyan
• Harvest Time Nurses
• Harvey L Carter III MD PA
• Alexa Harvey, LMT
• Allen Harvey, L.V.N.
• Amanda Virginia Harvey

• General Practice Dentistry in Dallas, TX
• Providers in Dallas, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; 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.