DR. DAVID SHANE PETRIE (NPI# 1104957521) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104957521 |
| Entity Type | Individual |
| Full Name | DR. DAVID SHANE PETRIE |
| Credential | DDS |
| Practice Address |
320 N Jeff Davis Dr Ste B Fayetteville GA 30214-1669 |
| Practice Telephone | 7704613921 |
| Practice Fax Number | 7704610944 |
| Mailing Telephone | 7704613921 |
| Mailing Fax Number | 7704610944 |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 122300000X | Dentist | 8534 | GA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003900440 | David Petrie | Family Medicine | 3946 Oneida St., New Hartford, NY 13413 | 2006-10-02 |
| 1265653992 | David Earl Petrie | Anesthesiology | 929 N Saint Francis St, Wichita, KS 67214-3821 | 2007-05-01 |
| 1326179581 | David Petrie | Marriage & Family Therapist | 1891 Effie St, Los Angeles, CA 90026-1793 | 2007-03-08 |
| Street Address |
320 N JEFF DAVIS DR STE B |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-1669 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962014696 | Neko Lynn Webb | Dentist | 2050 Skibo Rd Ste 104, Fayetteville, NC 28314-3161 | 2020-08-24 |
| 1225529605 | Alterman & Dhillon Eastern Nc, Pplc | Dentist | 4251 Ramsey St Ste 8&9, Fayetteville, NC 28311-2130 | 2018-05-22 |
| 1093217184 | Brandon Murray | Dentist | 2935 Breezewood Ave Ste 200, Fayetteville, NC 28303-5498 | 2018-03-05 |
| 1831641877 | Ryan Bradley | Dentist | 3500 Black Forest Dr Ste 1, Fayetteville, AR 72704-6551 | 2016-10-25 |
| 1750834255 | Sharitha Anderson | Dentist | 117 Pavilion Pkwy Ste 15c, Fayetteville, GA 30214-7732 | 2016-08-01 |
| 1992163901 | Dr Don M Chaney Dds Pa | Dentist | 1826 N. Crossover Road, Suite 2, Fayetteville, AR 72701 | 2016-02-04 |
| 1972973766 | Beautiful Smiles of Fayetteville | Dentist | 719 Lanier Ave W Ste A1, Fayetteville, GA 30214-7634 | 2015-10-06 |
| 1962870030 | Matthew Christian Alvarez | Dentist | 113 Ebenezer Rd Ste 101, Fayetteville, GA 30215 | 2015-09-08 |
| 1053795336 | Knowles, Smith & Associates, LLP | Dentist | 2028 Litho Pl Ste 300, Fayetteville, NC 28304-2538 | 2015-07-16 |
| 1952784159 | Christina Walls | Dentist | 637 E Joyce Blvd, #120, Fayetteville, AR 72703-6189 | 2015-07-07 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.