William D. Petty, DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

019-A14386 Issued in IL

Practice address

4233 W 95TH St
2ND Floor
Oak Lawn, IL 60462

Phone

(708) 636-2900

Fax

(708) 636-3337

NPI assigned

Dec 28, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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.

Opted out of Medicare

Yes, effective Oct 17, 2014 through Oct 17, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1167264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861558744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4233 W 95TH ST",
            "address_2": "2ND FLOOR",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "604532623",
            "telephone_number": "708-636-2900",
            "fax_number": "708-636-3337"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4233 W 95TH ST",
            "address_2": "2ND FLOOR",
            "city": "OAK LAWN",
            "state": "IL",
            "postal_code": "60462",
            "telephone_number": "708-636-2900",
            "fax_number": "708-636-3337"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETTY",
        "first_name": "WILLIAM",
        "middle_name": "D.",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "IL",
            "license": "019-A14386",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan N Peterson, RPH
• Karen L. Petracek, PA-C
• Amy Petraglia, DPT
• Jessica Lynn Petrisko, DNP, APRN
• Petty, Bielik & Burke Orthodontics, P.C.
• Sharon Therese Petzel, LCSW
• Nichole Natalie Pezeshki, LCSW
• Anna Kathryn Pfeiffer, PA-C
• Coleman Phair, DMD
• James Phelan, LPC

• Orthodontics and Dentofacial Orthopedics Dentistry in Oak Lawn, IL
• Providers in Oak Lawn, IL by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Illinois

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.