Active NPI
Odeta Petri, DDS
- Dentist
- Santa Ana, CA
National Provider Identifier
1831590231
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 63838
- Practice address
- 2231 S Bristol St
Santa Ana, CA 92704-5124 - Phone
- (714) 556-1001
- NPI assigned
- Sep 5, 2014
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 63838 | CA | Primary |
Addresses
Primary practice location
2231 S Bristol St
Santa Ana, CA 92704-5124
Mailing address
3700 S Plaza Dr
#KPH2
Santa Ana, CA 92704-7434
Phone (619) 610-8388
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63838 | CA | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Petri Dental Corporation | Current | Accepting new patients | |
| Akbar Heidarinia DMD Inc | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- General Practice Dentistry
- Orange, CA
- NPI 1225534407
-
- General Practice Dentistry
- Santa Ana, CA
- NPI 1306043872
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1409875200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415750400000",
"number": "1831590231",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3700 S PLAZA DR",
"address_2": "#KPH2",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927047434",
"telephone_number": "619-610-8388"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2231 S BRISTOL ST",
"city": "SANTA ANA",
"state": "CA",
"postal_code": "927045124",
"telephone_number": "714-556-1001"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRI",
"first_name": "ODETA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-09-05",
"last_updated": "2014-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "63838",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Santa Ana, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.