Patrick Joseph Petley, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

12078 Issued in NC

Practice address

3445 Henderson Dr
Jacksonville, NC 28546-5233

Phone

(910) 347-1283

NPI assigned

Mar 10, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Lane and Associates Xliii DDS PA

  • Dentist
  • Jacksonville, NC
  • NPI 1467113332

  General Practice

  NPD (past)
• Thomas E & Kimberly M Morgan DDS PA

  • General Practice Dentistry
  • Jacksonville, NC
  • NPI 1023133212
  NPD (past)

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

{
    "created_epoch": "1268179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782259200000",
    "number": "1699098350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3445 HENDERSON DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465233",
            "telephone_number": "910-347-1283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3445 HENDERSON DR",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465233",
            "telephone_number": "910-347-1283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETLEY",
        "first_name": "PATRICK",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-03-10",
        "last_updated": "2026-06-24",
        "certification_date": "2026-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NC",
            "license": "12078",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "PA",
            "license": "DS024517L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Everett Peters, IDC
• Jeri L Petersen, LPC
• Aileen Marie Peterson
• Darin Lee Peterson, MA, LAT, ATC
• Lavoncia Regan Peterson, LCSW, LCASA
• Trista A Petrella-McMullen, LPN, LMBT
• Margaret A Petry, APRN-CNM
• Jessica Lea Petty, IDC
• Lucia Philipp
• Sarah Faye Cowell Phillips

• Endodontics in Jacksonville, NC
• Providers in Jacksonville, NC by specialty
• Endodontics in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.