Cristian Petcu, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

20407 Issued in MA

Practice address

74 Main St
Medway, MA 02053-1824

Phone

(508) 533-8433

NPI assigned

May 14, 2007

Last updated

Aug 28, 2014By the provider in NPPES

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

State licenses

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

• Cristian Petcu DDS PC

  • General Practice Dentistry
  • Medway, MA
  • NPI 1801041652
  Authorized official Same address or phone

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

{
    "created_epoch": "1179100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409184000000",
    "number": "1932314747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 MAIN ST",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020531824",
            "telephone_number": "508-533-8433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 MAIN ST",
            "city": "MEDWAY",
            "state": "MA",
            "postal_code": "020531824",
            "telephone_number": "508-533-8433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETCU",
        "first_name": "CRISTIAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-14",
        "last_updated": "2014-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MA",
            "license": "20407",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0206318",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• General Practice Dentistry in Medway, MA
• Providers in Medway, MA by specialty
• General Practice Dentistry in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2014; 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.