William T. Petrey, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7236 Issued in KY

Legal business name

WILLIAM T. PETREY, DMD

Practice address

2725 US Hwy 25 North
E. Bernstadt, KY 40729

Phone

(606) 843-6476

Fax

(606) 843-6176

NPI assigned

Feb 4, 2009

Last updated

Jun 29, 2011By 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. William Todd Petrey, DMDNPI 1144323221

Title

Denitist/Owner

Phone

(606) 843-6476

Specialties & licenses 1

Addresses

Other identifiers 3

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.

• William Todd Petrey, DMD

  • General Practice Dentistry
  • East Bernstadt, KY
  • NPI 1144323221
  NPD (past) Authorized official

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1309305600000",
    "number": "1689812208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2725 US HWY 25 NORTH",
            "city": "E. BERNSTADT",
            "state": "KY",
            "postal_code": "40729",
            "telephone_number": "606-843-6476",
            "fax_number": "606-843-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2725 US HWY 25 NORTH",
            "city": "E. BERNSTADT",
            "state": "KY",
            "postal_code": "40729",
            "telephone_number": "606-843-6476",
            "fax_number": "606-843-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM T. PETREY, DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-04",
        "last_updated": "2011-06-29",
        "status": "A",
        "authorized_official_last_name": "PETREY",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "TODD",
        "authorized_official_title_or_position": "DENITIST/OWNER",
        "authorized_official_telephone_number": "606-843-6476",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "7236",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60072360",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100074220",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100088910",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 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.

Verify at the official NPI Registry.