Active NPI
Samantha Petrone, RDH, BSDH
- Dental Hygienist
- Fairlee, VT
National Provider Identifier
1992166011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 015.0001492
- Practice address
- 1596 King Hill Rd
Fairlee, VT 05045-9613 - Phone
- (802) 333-3764
- NPI assigned
- Mar 16, 2016
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 015.0001492 | VT | Primary |
Addresses
Primary practice location
1596 King Hill Rd
Fairlee, VT 05045-9613
Mailing address
1596 King Hill Rd
Fairlee, VT 05045-9613
Phone (802) 333-3764
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 |
|---|---|---|---|
| 015.0001492 | VT | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1458086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1458086400000",
"number": "1992166011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1596 KING HILL RD",
"city": "FAIRLEE",
"state": "VT",
"postal_code": "050459613",
"telephone_number": "802-333-3764"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1596 KING HILL RD",
"city": "FAIRLEE",
"state": "VT",
"postal_code": "050459613",
"telephone_number": "802-333-3764"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PETRONE",
"first_name": "SAMANTHA",
"name_prefix": "Ms.",
"credential": "RDH, BSDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-03-16",
"last_updated": "2016-03-16",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "VT",
"license": "015.0001492",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairlee, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.