Demetrios Petropoulos, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

09990 Issued in CT

Practice address

514 W Main St
Norwich, CT 06360-5321

Phone

(860) 889-5166

Fax

(860) 887-8254

NPI assigned

Jan 19, 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

Enrolled in CT

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

Practice roles

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.

• Norwich Smiles Family Dentistry

  • General Practice Dentistry
  • Norwich, CT
  • NPI 1558670471
  NPD (past)

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

{
    "created_epoch": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1361404800000",
    "number": "1992785695",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "514 W MAIN ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063605321",
            "telephone_number": "860-889-5166",
            "fax_number": "860-887-8254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "514 W MAIN ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063605321",
            "telephone_number": "860-889-5166",
            "fax_number": "860-887-8254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROPOULOS",
        "first_name": "DEMETRIOS",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2013-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CT",
            "license": "09990",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Marie Pernal
• Perspective Counseling Services LLC
• Jacob Edward Peterson, MD, MBA
• Jodi Sandra Peterson, LIC PROF COUNSELOR
• Michael William Petrides, M.S.(R), ABD, LPC
• Sandra Fortier Philips, LCSW
• Colleen Ellen Phillips-White, L.C.S.W.
• Sarah Piekarczyk
• Nicole Ann Pierce
• Ashley Pierre, LMFT

• General Practice Dentistry in Norwich, CT
• Providers in Norwich, CT by specialty
• General Practice Dentistry in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2013; 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.