Donna Jean Petro

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

13002646A Issued in IN

Practice address

1324 Tippecanoe St
Lafayette, IN 47904-2051

Phone

(765) 742-1567

Fax

(765) 429-2794

NPI assigned

Feb 9, 2023

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Riggs Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Lafayette, IN
  • NPI 1386660900
  NPD
• Riggs Community Health Center Inc

  • Federally Qualified Health Center (FQHC)
  • Lafayette, IN
  • NPI 1386876233
  NPD (past)

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

{
    "created_epoch": "1675900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675900800000",
    "number": "1992402994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1324 TIPPECANOE ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042051",
            "telephone_number": "765-742-1567",
            "fax_number": "765-429-2794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1324 TIPPECANOE ST",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479042051",
            "telephone_number": "765-742-1567",
            "fax_number": "765-429-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETRO",
        "first_name": "DONNA",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-02-09",
        "last_updated": "2023-02-09",
        "certification_date": "2023-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "IN",
            "license": "13002646A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Desmangles Counseling LLC
• Jeanne Yong-Tai Peterson, PHARMD
• John Peterson III
• Mark P Peterson, MD
• Stephen Peterson, LCSW,LCAC
• Thomas Petry, MD
• Ashley Pezzarossi, RBT
• Kristi Pfledderer, RBT
• Linda Kim Phan, MD
• Phebus Behavioral Health LLC

• Dental Hygienist in Lafayette, IN
• Providers in Lafayette, IN by specialty
• Dental Hygienist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.