Katelyn Marie Petraglia, DMD

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DS041328 Issued in PA

Practice address

117 Fox Plan Rd Ste 201
Monroeville, PA 15146-2723

Phone

(412) 372-2510

NPI assigned

Nov 20, 2017

Sex

Female

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

Enrolled in PA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1511136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1730693227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 RICHMOND DR",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "152151042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 FOX PLAN RD STE 201",
            "city": "MONROEVILLE",
            "state": "PA",
            "postal_code": "151462723",
            "telephone_number": "412-372-2510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5701 Centre Ave Ste Ll4",
            "address_purpose": "LOCATION",
            "city": "Pittsburgh",
            "state": "PA",
            "postal_code": "152063787",
            "country_code": "US",
            "telephone_number": "412-661-7500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PETRAGLIA",
        "first_name": "KATELYN",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-11-20",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS041328",
            "primary": false
        },
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "PA",
            "license": "DS041328",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lyndsey Peters, M.S., CF-SLP
• Christina Petersen
• Benjamin Bernard Peticca, MD
• Kathryn Diana Peticca, M.D.
• Petra General Trading LLC
• Shane Petrelli
• Jessica Petrie
• Debra Petrosky, PTA
• Emma C Pevarnik, PA
• Cong Thanh Phan, MD

• Endodontics in Monroeville, PA
• Providers in Monroeville, PA by specialty
• Endodontics in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.