Active NPI
David Anthony Petti, D.D.S.
- Oral and Maxillofacial Surgery (Dentist)
- Mamaroneck, NY
National Provider Identifier
1841402096
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 045989
- Practice address
- 1600 Harrison Avenue
Mamaroneck, NY 10543 - Phone
- (914) 698-4090
- Fax
- (914) 698-2195
- NPI assigned
- May 3, 2007
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 045989 | NY | Primary |
Addresses
Primary practice location
1600 Harrison Avenue
Mamaroneck, NY 10543
Mailing address
1600 Harrison Avenue
Mamaroneck, NY 10543
Phone (914) 698-4090
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 |
|---|---|---|---|
| 045989 | NY | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178150400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1841402096",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1600 HARRISON AVENUE",
"city": "MAMARONECK",
"state": "NY",
"postal_code": "10543",
"telephone_number": "914-698-4090",
"fax_number": "914-698-2195"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1600 HARRISON AVENUE",
"city": "MAMARONECK",
"state": "NY",
"postal_code": "10543",
"telephone_number": "914-698-4090",
"fax_number": "914-698-2195"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETTI",
"first_name": "DAVID",
"middle_name": "ANTHONY",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "NY",
"license": "045989",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mamaroneck, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.